Wildwood School Application/Enrollment Form

Wildwood School Application/Enrollment Form
Applicant Information
Student's Name*

First NameMiddle NameLast Name
Student's Preferred Name
Gender*
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
List any allergies, medical conditions, special health concerns, needs or diagnosis
Student's T-Shirt Size

Education Information
The grade student will be entering in the 2025-2026 School Year*
Enrollment Status
How many days a week are you wanting to enroll in?*

4 days M-TH3 days T-TH
Educational Background

If your child attended a school, hybrid, or other learning centers please fill out.
Name of School
School Address

Street

Street Address Line 2

CityState

Postal / Zip Code

Contact In case of Emergency

Please list a person that is not a parent or gaurdian
Name*

First NameMiddle NameLast Name
Relationship*
Mobile Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please list hospital of choice in case of the need to transport.
Additional Pick-up Person

Other than parents/guardians, your child will only be released to the following individuals. Please list name and relation.
Name*

First NameLast Name
Relation to Student*
Name

First NameLast Name
Relation to Student

*All applications are equitably reviewed. Acceptance into Wildwood Learning Center is based upon the compatibility of the family, the student, and the school. By signing my name below, I understand that my child will only be accepted into Wildwood Learning Center upon the successful completion of enrollment steps which include... The completion of this application and a non-refundable application fee of $50 paid to the school, an in-person interview with the student and family conducted by staff members. I understand that Wildwood Learning Center has the right and discretion as an independent educational institution to make any decisions deemed necessary regarding enrollment and acceptance into the school. By signing my name (parent/guardian ) below, I acknowledge Wildwood's admissions and acceptance process. I have reviewed and accepted all policies stated within the document. Please sign and date below.
Signature

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Enrollment Fee
$155.40 Quantity

Total

$0.00
Payment Methods

Fastlane Checkout

Choose from one of the PayPal options to make your payment.

Contact Info

Payment Info
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Applicant Information