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Your journey towards a healthy integration of work and life has just begun. [Sigh, Smile, Relax.)

Our application process is designed to help us understand you, your family, and your specific needs, so that each membership is tailored to your unique situation.

In addition to our high-end childcare program and curriculum, all members enjoy a range of exclusive perks and offerings, including date nights, fitness classes, wellness services, parent, family and community events and discounts with global and local brands. (*subject to location) We hope you join the Haven community!

Application Form

Step 1 of 8

12%

About You

Please select your location:(Required)

New Jersey

Rhode Island

Your Name(Required)

First Last

Phone(Required)

Email(Required)

Your Address

Street Address Address Line 2 City State ZIP Code

What is your current occupation?

We offer a 10% military & first responder family discount. Does your family qualify for this?

Yes

How did you hear about us?(Required)

If you were referred please let us know who to thank!

How Can We Reach You?

We would love to chat with you. How can we get in touch?

Preferred Method of Contact

Your Email Address(Required)

Enter Email Confirm Email

Your Phone(Required)

Best Time to Call You(Required)

Do you want to add a spouse, partner or caregiver to your application?

Yes

Spouse, Partner or Caregiver Information

Name

First Last

What is their current occupation + employer?

Will they be utilizing our coworking | fitness facilities?

Yes

Kiddos

How many children will you be including in our child development program?

Child 1 Info

Child 1 Name

First Last

Child 1 Date of Birth

Month

Day

Year

Which age group will Child 1 be applying to?

Note that we will assign your room based on development and age, so please select the age group you think is closest to that of your child:

Child 2 Info

Child 2 Name

First Last

Child 2 Date of Birth

Month

Day

Year

Which age group will Child 2 be applying to?

Note that we will assign your room based on development and age, so please select the age group you think is closest to that of your child:

Child 3 Info

Child 3 Name

First Last

Child 3 Date of Birth

Month

Day

Year

Which age group will Child 3 be applying to?

Note that we will assign your room based on development and age, so please select the age group you think is closest to that of your child:

Preferred childcare Schedule + Hours:

Please enter your estimated needs in order for us to best tailor your membership.
NJ: Hours 8 AM - 6 PM, Full day and Half Day pickup options available
RI: Hours 7:30 AM - 5:30 PM, Full day, Half day and 7:30-3:00 PM pickup options available
Example: "Looking for 2-3 full days per week" or "Looking for 3 afternoons per week" etc.
We will be in touch about options and availability. If we do not have what you are looking for, you will be added to our waiting list. All memberships include unlimited coworking and fitness access.

Infant through Preschool
Half days: 8am-12pm, 2pm-6pm
Full days: 8am-6pm
*minimum 2 half days per week

Preferred Schedule

💡 We currently have full and part time availability in some age groups. We will be in touch with you about available options based on your preferred schedule and start date.

When is your ideal start date?

MM slash DD slash YYYY

Members willing to commit to a 12 month membership may be moved to the top of the wait list. Is this something you would be interested in?(Required)

Yes

Is there anything which you would like us to know as it relates to your family’s or children’s needs?