ELC Enrollment Form
Please fill this form out for enrollment in the Trinity ELC. This form is for 6 weeks through 5 years and also for ages 5+ for summer care, drop in care, and before and after care.
Email address *
Child First Name *
Child Last Name *
Child's Date of Birth *
MM
/
DD
/
YYYY
Requested Start Date (must be at least two weeks from date of enrollment) *
MM
/
DD
/
YYYY
Parent 1 Name *
Parent 1 Email *
Parent 1 Phone Number *
Parent 2 Name
Parent 2 Email
Parent 2 Phone Number
I understand that all of the following paperwork must be submitted prior to my child's start date: *
Required
My Brightwheel account is updated with all requested information: *
Required
I understand that my registration fee is due at time of enrollment, and I will pay through Brightwheel billing. *
Does your child have any known health conditions/allergies? If yes, please explain *
Is your child currently taking medications? *
Does your child have a 504 plan? *
Does your child have an IEP? *
If you are enrolling in before and after care (K-8 ONLY), please answer the following
Clear selection
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy