Sunflower Sprouts Enrollment - Sunflower Creative Arts

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

First Parent First Name

First Parent Last Name

First Parent Phone

First Parent Email

First Parent Occupation

If stay at home parent please list prior occupation

First Parent Employer

If stay at home parent please list prior employer

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

Second Parent First Name

Second Parent Last Name

Parent Two Phone

Parent Two Email

Parent Two Occupation

If stay at home parent please list prior occupation

Parent Two Employer

If stay at home parent please list prior employer

Address 1

Address 2

City

State

Zip code

Child's First Name

Child's Last Name

Name child goes by (given or nickname)

Child's Birth Date

Placement

I accept the placement I have been offered for my child through the email I received from Sunflower.

I accept the placement I have been offered for my child BUT I would also like to be placed on the waitlist for the following programs or combo of programs.

I decline the placement, but I would like to be placed on the waitlist for the following programs or combo of programs.

I decline the placement offered to above child and don’t want to be waitlisted for any programs.

You will receive an email confirmation if you do not receive one please contact us
email: Seedlings@SunflowerCreativeArts.org - phone: 561 501-6615

Please help us get to know your family better by providing the following details. Thank you

First Name of sibling number one

younger or older sibling of child you are enrolling

Birth Date of sibling number one

First Name of sibling number two

younger or older sibling of child you are enrolling

Birth Date of sibling number two

First Name of sibling number three

younger or older sibling of child you are enrolling

Birth Date of sibling number three

Is there anyone else that you haven't already listed above who is important to your child that we should know about?

May we share your contact info (emails and phone numbers) with other current families in your class?

Yes No

Photo/Video Release

I accept

I do NOT accept

I Accept

Sprouts Enrollment

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

Sunflower Enews

Success!

Sunflower Creative Arts