Parent/Guardian Information *

First Name
Last Name
Phone Number
E-mail

How many children are you enrolling?

Select all ages you are enrolling *

Infant (6 weeks -12 months)

Toddler (1-3 years)

Pre-school (3-5 years)

Before & After-school (5-12 years)

What is your work schedule? *

Will you be using Private Pay or Publicly Funded Child Care (PFCC)? *

How soon are you looking to start? *

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Message Consent

I consent to receive non-marketing text messages from Dorise-Brown Fitness & Learning Academy about my order updates, scheduling updates, appointment reminders, and important program notifications. Message & data rates may apply.