Registration Form

Registration Form
Thank you for your interest in The Early Learning Nest! We are excited to learn more about your family and your child(ren).

Enrollment is completed through the following steps:

1. Complete the Registration Form and required documents.
2. Payment of the one-time, non-refundable $25 Registration Fee.
3. Applications are reviewed for program fit and availability.
4. Approved families will be contacted directly for a welcome meeting and will receive an Enrollment Packet.
5. Enrollment is finalized once all enrollment documents, fees, and required records are submitted.

Tours can be scheduled at any time throughout the process by booking a tour online.

If you are registering more than one child, please submit a registration form for each child. Contact us at info@earlylearningnest.com for a coupon of 50% off of the second child's Registration Fee.

Child Demographic Information
Full Name

First NameMiddle NameLast Name
Preferred Name/Nickname
Date of Birth

MonthDayYear
Gender
Home Address
Please list any allergies or medical conditions.
Please list any dietary restrictions.
Languages Spoken at Home

Other
Desired Start Date

Child Development Information
The following items are for informational purposes only in order to understand your child and their needs better. Answers to these questions will not be used to determine eligibility.
Does your child have any interests or hobbies?
What are your child's strengths?
Has your child previously attended daycare or preschool?
If yes, where?
Does your child have any fears, sensitivities, or concerns?
Is your child potty trained?
Note: Enrollment decisions regarding potty training are reviewed on a case-by-case basis. The preference is that children are, at minimum, daytime potty trained.
Please share any additional information that may help us support your child's transition and learning experience.

Parent/Guardian Information
Parent/Guardian 1
Full Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
Home Address
Relationship to Child
Parent/Guardian 2
Full Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
Home Address
Relationship to Child

Immunizations

Children enrolled at The Early Learning Nest must have current immunization records and any state-required health documentation submitted prior to their start date, unless a valid exemption is provided in accordance with Virginia state regulations.
Select all immunizations your child has received and is up-to-date on, if applicable.

Program Expectations
How did you hear about us?
What makes you interested in The Early Learning Nest?
Do you have any goals for your child's preschool experience?

Acknowledgements
I understand and agree to the following:

a) A non-refundable $25 Registration Fee is required to process this application.

b) Submission of registration forms and fee does not guarantee enrollment but reserves a space for my child pending completion and approval of the enrollment process. Enrollment is not guaranteed until all program requirements have been met.

d) Enrollment decisions are based on availability, program fit, and completion of required documents. Any concerns will be discussed with families prior to a final decision.

e) I will provide a copy of my child's birth certificate or other legal documentation showing proof of age.

f) If approved for enrollment, I will receive a personal welcome call and an Enrollment Packet with additional forms (emergency contact, authorized pickup, tuition agreement, etc.) that will need to be completed to completee enrollment.
Signature
Please verify that you are human

Responsible Party

First NameLast Name
Email Address for Payment Receipt
Payment information is processed securely through our third-party payment processor. We do not store, retain, or have direct access to your complete credit or debit card information.

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Registration Fee

$25.00 Quantity

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