Enrollment Form Parent/Guardian Name(Required) First Last Email (email is the primary source of contact)(Required) Phone(Required)City of Residence(Required) City Zip/ Postal Code Emergency Contact Name(Required) First Last Emergency Contact Phone(Required)Please list all names and ages of potential students over 5 years old.(Required)Does your child have allergies?(Required)Choose OneYesNoIf you chose YES for allergies, please list here:Tell us a little bit about your child(ren's) learning style and what grade you feel they are in.(Required)See below for reference.How many years have you been homeschooling?(Required)List additional siblings under 5 years old, include names and ages (if any).Do you consent to photos of you and your child being posted in BH Secular's private Facebook group?(Required)Choose OneYesNoWould you like to be placed on our wait list if all spots are filled?(Required)Choose OneYesNoAgreement(Required) By checking this box, I agree to abide by the Group Expectations and Guidelines in order to participate in Bright Horizons Secular Homeschool Group for the current semester.Fees(Required) By checking this box, I agree to pay the required fee and that there will be no refunds issued.
