Primary Contact First Name *

Primary Contact Last Name *

Child's Name *

Please include first and last name.

Child's Date Of Birth *

Phone *

Email *

This email will be used to complete registration and admissions paperwork through Brightwheel.

Child's School for Pick-Up *

Please note that enrollment is NOT complete until admissions paperwork has been submitted through Brightwheel.

You will receive an email with next steps after submitting this form.

Payment *

$ 10

One-time $10 registration fee required to reserve your child’s spot and begin the enrollment process.

I understand that my child’s enrollment is not finalized until the Brightwheel admissions packet is completed.