Registration


Welcome to New Life Care! Use this form to register for our Summer Care program, Our Preschool Summer Session, After-School Care for 2021-2022 or Preschool 2021-2022 sessions. Text or call Ketrah Holley at 251-525-3938 for assistance or for more info.

*   denotes required fields

Referral Information
Family Information
Where do you live?
Additional Info
Contact #1
How Can We Contact You?
Portal Access (your email is your login)
(Emails are kept confidential)
Who is your employer?
Contact #2
How can we contact you?
(Emails are kept confidential)
Who is your employer?
Student #1
(format=mm/dd/yyyy)
Additional Info

For Summer Care- Please enroll your child in the class listed for their current grade level during the 2020-2021 school year. We ask that you communicate with us how many days a week you are planning for your child to attend. 

 

For After-School Care- Please enroll your child in the class for the school they attend. Also, please be sure that you include their age and grade level.

Enroll in Classes
Select Class *
Required Policies and Agreements
 (Show-Hide Details)
I Agree to All of the Above
Questions or Concerns
Payment Information
Account Information
Credit Card