2025-2026

Application For Enrollment

Berrybrook was created for all children and their families whatever their race, religion, cultural heritage, political beliefs, national origin, marital satus, sexual orientation, disability, or toilet training status.

Website *

Full Name*

Preferred name:

(for example: Tommy for Thomas. This will be the name used for nametags, cubbies, class lists, etc.)

Returning Family:*

Yes No

Date of Birth:*

Age in September 2025*

years months

Gender:*

Male Female

Parent 1 Name:*

Address:*

Town & Zip:*

Home Phone:*

Cell Phone:*

Occupation:*

Business Name:*

Business Phone:*

Parent 2 Name:*

Address:*

Town & Zip:*

Home Phone:*

Cell Phone:*

Occupation:*

Business Name:*

Business Phone:*

Family Email Address*

Other Members of the Household:*

Previous Group Experience:*

New Families:*

How did you hear about Berrybrook?

Program Preference*

Beginners

2 Day AM

3 Day AM

4 Day PM

5 Day AM

For 2, 3, 4, 5 Day Classes:*

Are you interested in Lunch Bunch additional programming?

Yes No

If yes, for how many days?*

n/a

1 day

2 days

3 days

4 days

5 days

(please choose number of interested days, not to exceed # of days of regular programming. This only indicates interest at this time.)

Parent Signature*

Date:*

Your application’s not complete until you submit a non-refundable application fee of $50.00.
Cash, check, or Venmo (@berrybrook267) accepted.