Information Request
Note
Please allow 24-48 hours to review and respond to this form. For a faster response please feel free to call 413-356-0557 or email info@rootedthroughnature.com
Parent's Information:
*
Phone:
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Cell
Can you receive texts on this number?
Yes
No
Email:
*
Would you rather a follow-up call or an email?
Call
Email
Choose Which Program of Interest?
*
Red Maple Program - Ages 4 to 6
White Oak Program - Ages 7 to 13
American Elm Program - Ages 14 to 17
Multiple Programs for Multiple Students
Unsure Which Program?
What questions can we answer to help enroll your child(ren) in or our programs?
*
Date to Start:
Fall Semester
Spring Semester
All Year
How Many Child Might Attend?
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One
Two
Three
Four+
Student's Information #1
Student's Information #2
Student's Information #3
Student's Information #4
Any Additional Questions or Comments:
How did you hear about us?
*
Facebook, Instagram, Google... If from a friend, write their name for both to receive $10 off tuition!
Submit
Should be Empty: