Enrollment Form

PARENT INFORMATION

Parent 1 First Name

Parent 1 Last Name

Parent 1 Email

Parent 1 Phone Number

Parent 2 First Name

Parent 2 Last Name

Parent 2 Email

Parent 2 Phone Number

STUDENT INFORMATION

Student First Name

Student Last Name

Student Preferred Pronouns

Student Birthdate

Student Grade

Student Allergies:

Student Medical Conditions:

Student Special Needs or Accommodations:

EMERGENCY CONTACT

First Name

Last Name

Phone Number

Relation to Student

AUTHORIZED PICK UP

First Name

Last Name

Phone Number

Relation to Student

STUDENT RELEASE

Released to After School Launch Program

Authorized to Walk Home Unattended

ENRICHMENT CLASS ENROLLMENT

Invoices will be Sent AFTER Class Minimum is Achieved.
Flexible Payment Options Will Be Available.

2025 FALL
ENRICHMENT PROGRAM

September 30, 2025 - December 12, 2025

TUESDAYs

WEDNESDAYs

THURSDAYs

FRIDAYs

2026 WINTER
ENRICHMENT PROGRAM

January 6, 2026 - March 13, 2026

TUESDAYs

WEDNESDAYs

THURSDAYs

FRIDAYs

2026 SPRING
ENRICHMENT PROGRAM

March 24, 2026 - May 29, 2026

TUESDAYs

WEDNESDAYs

THURSDAYs

FRIDAYs

Terms and Conditions

I acknowledge that I have read and agree to the Terms and Conditions .

Refunds and Cancellations

I acknowledge that I have read and agree to the Refunds and Cancellations .

Enrollment Policy:

Enrollment is not guaranteed. Class placement will be assigned in the order in which enrollments are received.
If a class reaches capacity, additional enrollments will be placed on a waitlist and notified of their status.

Have you submitted a scholarship application for this program?

Yes No

1425 Broadway, Ste 487
Seattle, WA. 98122

LeschiES
Website

Enrichment
By Class Program

Enrichment
By Grade Level

Enrichment
By Season

Scholarship
Application

Enrichment
Registration

Enrichment
Management

Enrollment Form

PARENT INFORMATION

STUDENT INFORMATION

EMERGENCY CONTACT

AUTHORIZED PICK UP

STUDENT RELEASE

ENRICHMENT CLASS ENROLLMENT

Invoices will be Sent AFTER Class Minimum is Achieved.
Flexible Payment Options Will Be Available.

2025 FALL
ENRICHMENT PROGRAM

September 30, 2025 - December 12, 2025

2026 WINTER
ENRICHMENT PROGRAM

January 6, 2026 - March 13, 2026

2026 SPRING
ENRICHMENT PROGRAM

March 24, 2026 - May 29, 2026

Enrollment is not guaranteed. Class placement will be assigned in the order in which enrollments are received.
If a class reaches capacity, additional enrollments will be placed on a waitlist and notified of their status.

1425 Broadway, Ste 487
Seattle, WA. 98122

info@EnrichmentManagement.com

Copyright© 2024
Enrichment Management LLC

Enrollment Form

PARENT INFORMATION

STUDENT INFORMATION

EMERGENCY CONTACT

AUTHORIZED PICK UP

STUDENT RELEASE

ENRICHMENT CLASS ENROLLMENT

Invoices will be Sent AFTER Class Minimum is Achieved. Flexible Payment Options Will Be Available.

2025 FALL ENRICHMENT PROGRAMSeptember 30, 2025 - December 12, 2025

2026 WINTER ENRICHMENT PROGRAMJanuary 6, 2026 - March 13, 2026

2026 SPRING ENRICHMENT PROGRAMMarch 24, 2026 - May 29, 2026

Enrollment is not guaranteed. Class placement will be assigned in the order in which enrollments are received. If a class reaches capacity, additional enrollments will be placed on a waitlist and notified of their status.

1425 Broadway, Ste 487 Seattle, WA. 98122

Copyright© 2024 Enrichment Management LLC

Invoices will be Sent AFTER Class Minimum is Achieved.
Flexible Payment Options Will Be Available.

2025 FALL
ENRICHMENT PROGRAM

September 30, 2025 - December 12, 2025

2026 WINTER
ENRICHMENT PROGRAM

January 6, 2026 - March 13, 2026

2026 SPRING
ENRICHMENT PROGRAM

March 24, 2026 - May 29, 2026

Enrollment is not guaranteed. Class placement will be assigned in the order in which enrollments are received.
If a class reaches capacity, additional enrollments will be placed on a waitlist and notified of their status.

1425 Broadway, Ste 487
Seattle, WA. 98122

Copyright© 2024
Enrichment Management LLC