JMAIIA Enrollment Intake

Parent / Guardian Info

Parent / Guardian Full Name

Email Address

Phone Number

Home City / Town

Child Information

Child’s Full Name

Child’s Date of Birth

Month

Day

Year

Child’s Age at Time of Enrollment

Which Program Are You Interested In?

Schedule & Needs

Preferred Schedule (If you chose Sprout House, select your preference. If Seed-to-Sky, choose N/A)

Does your child have any allergies, health conditions, or accessibility needs?

Tell us a little about your child’s personality, interests, or learning style.

How Did You Hear About Us?

How did you hear about the JMAIIA Center?

Agreement / Disclaimers

Early Enrollment Hold Terms

By reserving a space through our Early Enrollment Hold, you understand that the $100 deposit is non-refundable and will be applied toward your first month of tuition once enrollment is finalized.

Completing this intake form within 7 days of your deposit is required to confirm your child’s space. If the form is not completed within that time, your seat may be offered to the next family on the waitlist and the deposit will remain non-refundable.

I have read and agree to the Early Enrollment Hold terms above.

I agree to receive email updates about programs and enrollment at the JMAIIA Center.