2025 Bright Futures Enrollment Application

Free Full-Day Child Care Application

Bright Futures Learning Centers, Inc.

Dear Parents and/or Guardians,

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Thank you for your interest in the Bright Futures Learning Centers Inc’s certified Infant/Toddler, Pre-K, and Kindergarten program. Our Main Campus Location is:

1745 N. Cameron Street, Harrisburg PA 17103

Guidelines:

• Child must be 6 weeks to 6 yrs old before classroom start date.

• Family income guidelines must be met

• Return completed application with supporting documents to complete the pre-screening process

Required Documents Can Be Submitted After Approval:

➢ Proof of Income (W-2 or 3 most recent pay stubs - Or statement of employment status)

➢ Proof of Residency (Utility Bill or Driver’s License)

➢ Child’s Birth Certificate or Immigration Card

➢ Physical/Immunization Record

**If you have no income at this time you will still qualify**

Address Map Locator
Parent(or Guardian) Primary Address(REQUIRED)*

Street Address

Street Address Line 2

CityState

Zip Code
Type a question
Parent/Guardian Valid Mobile Phone Number(REQUIRED)*
Secondary Phone Number
Email(REQUIRED)*

Confirmation Emailexample@example.com

Child's Living Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County Where the Child Lives (REQUIRED)*
School District Where the Child Lives (REQUIRED)*
ALLERGIES (REQUIRED)*

FOOD ALLERGIESTEXTURE/TEXTILE ALLERGIESSCENT ALLERGIESPET ALLERGIESMEDICAL ALLERGIESNO ALLERGIES
PLEASE DESCRIBE YOUR CHILD'S ALLERGIES IN DETAIL
PLEASE DESCRIBE ANY OTHER MEDICAL, DIETARY OR SPECIFIC OTHER NEEDS (Medication Needs/Dietary Restrictions)

Does the Child Experience any of these Household Factors (REQUIRED)*
Does the Child Experience any of these Personal or Environmental Factors
Does the Child Experience any of these Living Household Factors

General Information Section
Schedule Your Enrollment Tour*
Please verify that you are human*
Please sign here*
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