Enroll Your Child

Complete the form below to begin the enrollment process.

We'll review your application and reach out within 1–2 business days.

Note: Fields marked with * are required.

Child Information

Child First Name *

Child Last Name *

Child Date of Birth *

Child Gender

Program Interest *

Schedule Preference

Desired Start Date

Parent Information

First Name

Last Name

Email *

Phone *

Relationship to Child

City

State

Postal Code

Additional Notes

By checking this box, I consent to receive non-marketing text messages from Passionate Hands of Mercy Academy about my child or children. Message frequency varies, message & data rates may apply. Text HELP for assistance, reply STOP to opt out.

By checking this box, I consent to receive marketing and promotional messages including special offers, discounts, new product updates among others, from Passionate Hands of Mercy Academy at the phone number provided. Frequency may vary. Message & data rates may apply. Text HELP for assistance, reply STOP to opt out.

Enroll Your Child

Child Information

Parent Information

Additional Notes

Submit Application