Inquiry Form Inquiry Please fill out the form below to receive additional information on the Children's Center of Brighton. Parent/Guardian Name * Parent/Guardian 2 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: reCAPTCHA Email If you are human, leave this field blank.