Enroll at Bright Leaders Daycare Inc.

Child's First Name *

Middle Name (optional)

Child's Last Name *

Preferred Name or Nickname

What does your child like to be called?

Date of Birth *

Sex *

Home Address *

Where does your child live?

Address

Demographics

This information is used solely for NYC Dept. of Health Forms

Is your child Hispanic or Latino? *

YesNoPrefer not to say

Transportation

This program offers transportation services for enrolled children.

Transportation Plan

Where to Find Schedule

White board

Transportation Provided By

Program staff

Car Seats

The program provides car seats for transportation (if applicable).

Full transportation policies and details will be included in your enrollment packet.

My child needs regular transportation

By selecting this, you confirm that your child will use the program's transportation services and you give permission for your child to be transported according to the plan described above.

Basic Information

Home Address *

Demographics

Transportation