Enrollment

We’re excited to welcome new families into our Bright Future Kiddie Care community! Our enrollment process is designed to be simple and convenient for you. Whether you’re enrolling for the first time or returning, we’re here to guide you through every step. Complete the enrollment form below to secure your child’s spot and provide them with the best in early childhood education and care. We can’t wait to partner with you in nurturing your child’s bright future!

Enrollment

Child's Information

Full Name*

Date of Birth*

Age*

Gender*

Home Address*

Additional Address Line 2 City State / Province / Region Postal / Zip Code Country

Parent/Guardian Information

Parent/Guardian #1 Name*

Relationship to Child*

Phone Number (Primary)*

Phone Number (Secondary)*

Email Address*

Parent/Guardian #2

Relationship to Child:

Phone Number (Primary):

Phone Number (Secondary):

Email Address:

Emergency Contact Information

Emergency Contact Name*

Relationship to Child :*

Emergency Contact Phone Number:*

Medical Information

Pediatrician's Name

Pediatrician's Phone Number

Allergies (Food, Medication, etc.)

Medical Conditions

Medications

Does your child have any special needs?

Any additional health concerns we should be aware of?

Authorized Pickup Information

Authorized Pickup Person's Name*

Relationship to Child :*

Phone Number (Primary): *

Phone Number (Secondary)

Enrollment Details

Preferred Start Date*

Enrollment Type*

Days of the Week for Care*

Payment Information

Payment Type*

Consent and Agreement

I, the undersigned, give my consent for the staff at Bright Future Kiddie Care to seek emergency medical treatment for my child.

Parent/Guardian Signature (Emergency Consent)*

Date*

I understand the policies and fees of Bright Future Kiddie Care and agree to abide by them.

Parent/Guardian Signature (Policies Agreement)*

Date *

Additional Child(ren) Information

Do you have additional children to register?*

Yes

Child 2 Information

Child 2 Name*

Child #2 - Date of Birth*

day

month

year

Do you have another child to register?*

Child 3 Information

Child #3 - Name*

Child #3 - Date of Birth*

day

month

year

Enrollment

Enrollment

Child 2 Information

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