Enrollment form

Enrollment Application
Childs Name*
Date of Birth*
Date Format: MM slash DD slash YYYY
Address*
Street Address Address Line 2 City ZIP Code
Pick one of our locations*
Email*
Parent / Guardian Name
Work Phone
Home Phone
Siblings
Name
Age
Sibling's Name
Sibling's Age
Additional Siblings
Schedule Requested
Schedule Requested
- Full Day (Drop off after TIME, Pick up before TIME)
- Part Day (Drop of after TIME, Pick up before TIME). Rittenhouse Square only*
- Before School (Drop off after TIME). Richboro only*
- After School (Arrives after school, Pick up before TIME). Richboro only*
Days Requested
- Select All
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
Estimated Drop Off Time:

: HH

MM
Estimated Pick up time:

: HH

MM
I would like my child to begin:
Date Format: MM slash DD slash YYYY
Verification
Please enter any two digits with no spaces (Example: 12)*
Please enter a number from 0 to 99.
CAPTCHA

Rittenhouse: 267-773-7588 | Churchville: 215-355-8801 | Richboro: 215-355-4116