Enrollment Application

Begin Your Child's Enrollment

Complete this structured application to start your enrollment with Insight Kidz Care.

After submitting, you'll continue to Brightwheel to complete required admissions documents.

Care begins at age 2 (licensed ages 2–12). Planning ahead? Families may apply early for a future start date on or after the child's second birthday.

Important: Completing this application begins your enrollment process only. Enrollment is not complete until all required admissions documents have been submitted and reviewed through Brightwheel.

Parent / Guardian

Primary contact for enrollment communication.

First Name *

Last Name *

Email *

Mobile Phone *

Child / Student

Information about the child enrolling in care.

Child First Name *

Child Last Name *

Date of Birth *

Gender (optional)

Home Address

Where your child will be picked up and dropped off.

Street Address

Apartment / Unit

City

State

ZIP Code

Program Preferences

What type of care are you looking for?

Desired Start Date

Meal Type / Dietary Needs (optional)

School Name (if transportation needed)

Child Care Scholarship

Maryland CCS (Child Care Scholarship) status.

Scholarship Status

Emergency Contact

Who should we contact if you are unreachable?

First Name

Last Name

Phone

Relationship to Child

Approved Pickup Person

Who is authorized to pick up your child?

First Name

Last Name

Mobile Phone

Additional Information

Additional Enrollment Details

A sibling also attends or will attend Insight Kidz Care I consent to receive SMS messages about my enrollment

Submitting this form starts your enrollment. You will still need to complete required admissions documents through Brightwheel.