If you would like more information about our center, please fill out the form below. We will contact you with tour and availability information.

Inquiry

Please fill out the form below to receive additional information on the Children's Center of Brighton.

Parent/Guardian First and Last Name *

Parent/Guardian 2 First and Last Name

Email Address *

Phone Number *

(best number to reach you during the day)

Street Address

City

State

Zip

Child 1 Name *

Child 1 Date of Birth *

Child 2 Name

Child 2 Date of Birth

Child 3 Name

Child 3 Date of Birth

We are interested in: *

Childcare: 6 weeks – 5 years old, full day

Kindergarten

Kindergarten Wrap

School Age Program

Days *

Full Time; Monday – Friday

Part Time: anything less than five days (select below)

Monday

Tuesday

Wednesday

Thursday

Friday

Flexible

Not flexible

Requested Start Date *

How did you hear about us?

Your Questions or Comments:

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