** ATTENTION ** Completing this form does not ensure a childcare spot at Pipsy's. This form is to request additional information. The enrollment process is as follows: 1. Complete the pre-enrollment form2. Wait to receive paperwork via email3. Complete and return all paperwork4. Activate Brightwheel account5. Pay deposit and confirm start date Parents Info Parent or Guardian One's Name Phone Number Parent or Guardian Two's Name Phone Number E-mail Address Preferred Method of Conact EmailText MessagePhone Call Child/Children Info Child/Children NamesDate of Birth or Due Date Program Pricing Wee Ones Nursery Care age 6 weeks to 24 months: Full Time $315/week Orange Class age 18 months to 36 months: Full Time $300/week Yellow Class age 3 - 4 years old: Full Time $290/week Green Class age 4 - 5 years old: Full Time $280/week Program Options Wee Ones Nursery Care age 6 weeks to 24 monthsOrange Class age 18 months to 36 monthsYellow Class age 3 - 4 years oldGreen Class age 4 - 5 years old Additional Information and/or Questions