Enrollment Form

Enrollment Form

We’d love to welcome you our little family!
Child’s Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Mother/Guardian’s Name

First NameLast Name
Mother’s Phone Number
Father/Guardian’s Name

First NameLast Name
Father’s Phone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact

First NameLast Name
Relationship to Child
Phone Number
Emergency Contact

First NameLast Name
Relationship to child
Phone Number
Projected Start Date

MonthDayYear
Date
Is your child potty trained?

YesNoIn Progress
Meal Plan

School MealsAll meals will be packed
Allergies
List any medical conditions staff may need to be aware of.
Email
example@example.com
All parents must throughly review policies and procedures before and after submitting an enrollment application. If your child(ren) are actively enrolled, you are expected to abide by every procedure or forfeit your child(ren) spot.

Once you complete this form, the $100 registration fee must be paid to continue your enrollment process. This is a non-refundable fee and does not go towards your first tuition payment.

Cash App $TheRainaAlexis

Zelle alexisraina@gmail.com
Shot Record

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How did you hear about us?

Social MediaReferralSearch engineOther
If someone referred you, please leave their name so we can thank them! :)
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