Enrichment Program Enrollment
In our enrichment program we value developing your child in a small setting that allows your child to learn and grow on their individual level. We work alongside you, as a parent, when it comes to learning their unique learning styles and developmental needs. Once form is completed and enrollment fee is received, a member of our team will contact you to schedule a time to meet and assess your child's individual developmental needs.
Parent Name
*
Parent Email Address
*
Home Address
*
Parent Phone Number
*
When would you like your child to begin? (MM/DD/YYYY) Classes begin January 13, 2020.
*
What days will your child be attending?
*
Monday's
Tuesday's
Wednesday's
Thursday's
Friday's
Child's Name
*
Child's DOB
*
Developmental Needs? Select all that apply
*
ABC Song/ ABC Recognition
Counting/ Number Recognition
Days of the Week
Color Recognition
Shape Recognition
Social Development
Potty Training
Please let us know a little about your current childcare situation? Please include the type of childcare environment has your child been in (daycare, family member's care, at home with parents, etc.). *
Allergies?
*
Emergency Contact/ Authorized Pick Up
*
Additional Information/ Concerns
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Enrollment Fee
$
40.00
Enrollment Fee- SIBLING
$
25.00
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