SIBLING ENROLLMENT FORM

To place a sibling of a currently enrolled child on the Wait List, please:

  1. Submit the form below
  2. Mail a check in the amount of $40 to the ChildRoots Main Office, Attn: Wait List, 1712 E Burnside St. Portland, OR 97214.

Once we confirm receipt of both, we will send you an email confirmation.

Preferred Location(s) *
Preferred Schedule *
Preferred Start Date *
Preferred Start Date
CHILD INFORMATION
Child DOB *
Child DOB
Name *
Name
Sibling Name *
Sibling Name
Name of currently enrolled child
PARENT CONTACT INFO
Parent Name *
Parent Name
Phone *
Phone