Online Application for Enrollment

URL

This field is for validation purposes and should be left unchanged.

Parent/Guardian Information

Full Name*

Email Address*

Phone Number*

Home Address*

Relationship to Child*

Preferred Method of Contact*

Phone

Email

Text

Child Information

Child’s Full Name*

Date of Birth*

Gender*

Male

Female

Preferred Start Date*

Days Needed*

Full-time

Part-time

Hours Needed*

Current School/Daycare

Allergies, Medical Conditions, or Special Needs

Additional Details

Is your child potty trained?*

Yes

No

Primary Language Spoken at Home*

Emergency Contact*

Authorized Pick-Up Persons*

Documents to Upload (Optional but Recommended)

Drop files here or

Max. file size: 100 MB.

Immunization Records
Birth Certificate
Emergency Medical Authorization
Recent Photo of Child

How Did You Hear About Us?

Google/Search Engine

Social Media

Word of Mouth

Flyer or Advertisement

Referred by a Current Family (please list name)

Referred by a Current Family

Online Application for Enrollment

Welcome to Curious Rose!

Parent/Guardian Information

Child Information

Additional Details

Get in Touch