Roots & Shoots Enrollment

Once you submit this form, you will receive a confirmation email from [email protected]. If you do not receive an email within an hour please let us know.

This ENROLLMENT form is for ONE child, if you are enrolling multiple children you will need to fill out this form for each child.


If stay at home parent please list prior occupation
If stay at home parent please list prior employer

If there is no second parent please put N/A in the following fields.


If stay at home parent please list prior occupation
If stay at home parent please list prior employer



If you have any questions, comments or concerns, Ashley, Susan or Ilysia would be happy to speak with you. You can get in touch with any of them by email or calling 561 501-6615.


You will receive an email confirmation if you do not receive one please contact us
email: [email protected] - phone: 561 501-6615

Once you submit this form, you will receive a confirmation email from [email protected]. If you do not receive an email within an hour please let us know.

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