✦ Enrollment Interest Application ✦

Start the Adventure

Fill out our enrollment interest form to get started. This does not guarantee enrollment — our team will review your application and reach out about availability, tuition, and next steps.

Mon–Fri · 6:00 AM – 6:00 PM

316-670-6620

Complete the form below›We review your application›We contact you about next steps›Your child's adventure begins! 🎉

Parent / Guardian Information

Tell us about the primary parent or guardian

Secondary Parent / Guardian (optional)

Full Name

Phone

Relationship to Child

Home Address

Child Information

Tell us about your little treasure

Child's Full Name*

Gender

Date of Birth*

Child's Age*

Does your child have any allergies?*

YesNo

Any medical conditions, medications, or special care needs?*

YesNo

Requested Attendance Schedule

Treasures Academy is open Monday–Friday, 6:00 AM–6:00 PM

Check each day your child will attend and set arrival and departure times. At least one day is required.

Monday

Tuesday

Wednesday

Thursday

Friday

Desired Start Date*

Is this schedule ongoing or temporary?*

OngoingTemporary

Emergency Contact Information

Who should we contact in case of emergency?

Primary Emergency Contact

Full Name*

Relationship to Child*

Phone Number*

Secondary Emergency Contact (optional)

Full Name

Relationship to Child

Phone Number

Authorized Pickup Information

Who is authorized to pick up your child?

Authorized Pickup 1*

Full Name*

Relationship*

Phone Number*

Are there any individuals NOT allowed to pick up the child?*

YesNo

Child's Needs & Routine

Help us understand your child's routine and any special needs

Does your child take naps?*

YesNo

Any food restrictions or dietary needs?*

YesNo

Any behavioral, emotional, developmental, or learning needs we should know about?*

YesNo

What helps comfort your child when upset?

Anything else you'd like us to know about your child?

Parent Agreement

Please read and sign below to complete your application

I understand that submitting this application does not guarantee enrollment. Treasures Academy will review the application and contact me regarding availability, next steps, required documents, tuition, and enrollment forms.

I have read and understand the agreement above. *

I have read and agree to the Parent Handbook policies, including fees, attendance, and behavior expectations. *

Parent / Guardian Signature (type your full name)*

Date*

Submitting this form does not guarantee enrollment. We will follow up with you directly.

Start the Adventure

Parent / Guardian Information

Child Information

Requested Attendance Schedule

Program Interest

Emergency Contact Information

Authorized Pickup Information

Child's Needs & Routine

How Did You Hear About Us?

Parent Agreement