Online Enrollment

We're excited to partner with you in your child’s early education and development. Please complete the enrollment form below for your child or children. It's important that all information provided is accurate and up to date so we can ensure the best care and communication for your family.

At ABC, your privacy matters. We take great care to protect the personal information you share with us. To learn more about how we handle and safeguard your data, please review our Privacy Policy.

Thank you for choosing ABC Child Care & Learning Center—we look forward to welcoming your little one!

Child 1

First Name

Last Name

Middle Name (if applicable)

Child's Gender

Boy

Girl

Prefer not to disclose

Child's Date of Birth

YYYY

Child 2

First Name

Last Name

Middle Name (if applicable)

Child's Gender

Boy

Girl

Prefer not to disclose

Child's Date of Birth

YYYY

Parent 1

First Name

Last Name

Parent 1's Phone

(###)

###

####

Parent 1's Email

Parent 2

First Name

Last Name

Parent 2's Phone

(###)

###

####

Parent 2's Email

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Are both parents authorized to pick up child(ren)?

Yes

If no to the above, please explain.

Additional Person(s) authorized to pickup child(ren)

First Name

Last Name

First Name

Last Name

First Name

Last Name

Person to call in case of emergency

Phone

(###)

###

####

Is there anything else you'd like us to know about your child?

Online Enrollment

A Place to Learn & Grow!

Resources

Programs

Upcoming Events

Center Info

Hours