CLC Enrollment Form

Enrollment Interest Form

Thank you for your interest in Crossroads Learning Center! Due to high demand, we often operate with a waiting list, and space is based on age group and classroom capacity. Some ages may have immediate openings, while others may take a little time, but we’d love the chance to talk with you and see what’s possible! To begin the process, please fill out the short interest form below. A member of our team will follow up with you to discuss current availability and answer any questions.
Parent/Guardian Information:
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Phone Number*
Parent/Guardian Email Address*
example@example.com
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Child Information:
Please tell us the Name, Date-of-Birth, and anything special we may need to know about each of the children you are interested in enrolling at CLC:*
If you have any specific questions about CLC, please type them below:
Thank you again for your interest in CLC!

Click SUBMIT Below. We will review your enrollment form and follow-up with you as soon as possible.
Should be Empty:

Enrollment Interest Form