Bright Start Enrollment Form
Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Nickname
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Child's Start Date *
MM
/
DD
/
YYYY
Please list previous Child Day Care Programs your child has attended. *
Your answer
Will your child attend another school or Child Day Care Program simultaneously with Bright Start? *
If you answered yes to the previous question, please provide the name of the school or program your child will attend.
Your answer
Is your child fully potty trained? *
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