New Student Inquiry Form
Child’s Name
*
First Name
Last Name
Parent's Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Child’s Birthdate
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Child’s age on August 1st. (Please include months.. ex: 2 years 3 months)
Is your child potty trained
*
Yes
No
Working currently on it
Thank you for your interest in registering your child. You will receive a text within a week to let you know if there is an open spot for the 2026-2027 school year. The $35 nonrefundable will be paid via our Brightwheel app, only after a spot has been secured for you. If and when a spot is secured for you, you will have 5 days to pay the $35 before releasing your spot to the next in line. Please sign below acknowledging you understand.
*
Submit
Should be Empty: