Valley Kids Learning Center Enrollment Request

If you have additional questions, we'd love to hear from you! Please email us at info@valleykidslearningcenter.org. If you are ready to take the next steps to get your child enrolled at Valley Kids Learning Center, please complete the form below. Once we receive the completed form, you will be contacted by one of our staff members who will be happy to help you complete the enrollment process. Thank you for considering the VKLC, we look forward to hearing from you!

Name of Parent *
Name of Parent
Address *
Address
Phone *
Phone
Name of Child 1 *
Name of Child 1
Name of Child 2
Name of Child 2
Name of Child 3
Name of Child 3
Child 1 - Date of Birth *
Child 1 - Date of Birth
Child 2 - Date of Birth
Child 2 - Date of Birth
Child 3 - Date of Birth
Child 3 - Date of Birth