Forms & Documents | Grace Early Learning

Enrollment Request Form

Please complete this form only if you are ready to move forward with enrollment. After your form is reviewed, our office will contact you and provide access to Brightwheel so you may complete the registration paperwork and be billed for the registration fee. At that time, your child will be added to our enrollment system. Please submit a separate Enrollment Request Form for each child enrolling at the center. Submission of this form does not guarantee enrollment or placement.

Child's Name

Child's Date of Birth

Month

Day

Year

Age at Start Date

Desired Start Date

Month

Day

Year

Parent/Guardian Name

Phone #

Email

Address

Program Requested

Schedule

Before/Aftercare School (If applicable)

Tour Taken?

Yes

No, I have not yet

Date of Tour

Month

Day

Year

I understand that I will receive access to Brightwheel to complete the required paperwork and pay the registration fee, and that enrollment is not complete until all paperwork, required documents, payment, and placement confirmation have been received.

Signature

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