Enrollment Forms - Wild Roots Holistic Learning Center

Wild Roots Temecula Enrollment Forms

(Looking for Rancho Santa Margarita enrollment forms? Those will be available soon!).

Please select the enrollment forms for the correct school year below.
Questions? Please reach out to our Center Director at lidia@wildroots.com.

Step 1 of 12

First Up, Introductions!

WHO DO WE HAVE THE PLEASURE OF ENROLLING

Child's Name(Required)

First Last

Child's Gender(Required)

Child's Birthdate(Required)

MM slash DD slash YYYY

WHO ARE THE PARENTS/GUARDIANS

PRIMARY CONTACT

Name(Required)

First Last

Relationship to Child(Required)

Parent

Guardian

Home Phone

Cell Phone(Required)

Email(Required)

Home Address(Required)

Street Address City State ZIP Code

SECONDARY CONTACT

Name(Required)

First Last

Relationship to Child 2(Required)

Parent

Guardian

Other

Home Phone

Cell Phone(Required)

Home Address(Required)

Same as Above

Different Address

Secondary Contact Address

Street Address City State ZIP Code

We understand that families come in many shapes and sizes, and we want to make sure everyone who cares for your child feels included and informed. If you’d like, we can send a welcome email (to the address above) about Wild Roots to the secondary contact listed above, inviting them to review our enrollment and consent forms. This helps us ensure that all caregivers stay connected and up to date.

Yes, please send them information about Wild Roots.

No, I'll share this information with them myself.

Other

Please Download and Fill Out these Essential Forms

Please download, fill out, and upload each file as required. And please include your child's immunization records as well.

Consent for Medical Treatment(Required)

Click Here to Download. Please fill out the form and upload below.

Accepted file types: pdf, Max. file size: 10 MB.

Child's Pre-Admission Medical History(Required)

Click Here to Download. Please fill out the form and upload below.

Accepted file types: pdf, Max. file size: 10 MB.

Notification of Parental Rights(Required)

Click to Download. Please fill out the form and upload below.

Accepted file types: pdf, Max. file size: 10 MB.

Child's Physician Report (Filled Out by Doctor)(Required)

Click to Download. Please fill out the form and upload below.

Accepted file types: pdf, Max. file size: 10 MB.

Personal Rights Form(Required)

Click to Download. Please fill out the form and upload below.

Accepted file types: pdf, Max. file size: 10 MB.

Identification & Emergency Information(Required)

Click to Download. Please fill out the form and upload below.

Accepted file types: pdf, Max. file size: 10 MB.

Individual Infant Sleeping Plan(Required)

Click to Download. Please fill out the form and upload below.

Accepted file types: pdf, Max. file size: 10 MB.

Immunization Record(Required)

Please upload your own record(s) below.

Accepted file types: pdf, Max. file size: 10 MB.

Admissions Agreement & Consent

Review the Admissions Agreement Form

➡️ Click Here to Download and Review the 2025-2026 Admissions Agreement
NOTE: You don't have to re-upload it. You can fill out the options below and sign at the end of this form.

Confirm You Have Read, Reviewed and Agreed(Required)

By checking this box, I am indicating that I, the child's parent or guardian, have read, understand, and agree to all terms outlined in Wild Roots’ 2025-2026 admissions agreement.

Consent for Photography and Information for Publication

Wild Roots Holistic Learning Center, Inc. will regularly take photographs and/or video footage of children engaged in activities. This content will be utilized in creating project documentation, as well for promotional purposes which include but are not limited to marketing materials, web content, social media content including Facebook, Instagram, Twitter, YouTube. Wild Roots creates content in order to enrich our school community involvement, and to spread the Wild Roots message to likeminded families.

Select Your Choice(Required)

By checking this box, you give permission for professional and appropriate photography and/or video footage to be taken of your child and used in any capacity listed above, without the necessity for Wild Roots to obtain specific permission from you for each instance. Your child’s name will not be mentioned or tagged in any content at any time, but their likeness may appear in Wild Roots in-school and/or web content, and/or on Wild Roots social channels periodically. Your child will be included in photos and/or video footage of classroom activity. Additionally, they will appear in the 2025-2026 yearbook.

By checking this box, you hereby do NOT give permission for any photography or video footage to be taken of your child whatsoever. By initialing here, you are ensuring that your child will not under any circumstances be included in Wild Roots in-school or web content, or on Wild Roots social channels at any time for any reason. Your child will not be included in photos or video footage of classroom activity. Additionally, they will not appear in the 2025-2026 yearbook (by default, your child’s school portrait will still be taken, and will be kept private, available only to you for order).

Tuition Rates & Fees (Monthly Per Classroom)

Review the Tuition Rates & Fees

➡️ Click Here to Download and Review the 2025-2026 Tuition Rates and Fees
NOTE: You don't have to re-upload it. You can fill out the options below and sign at the end of this form.

Confirm You Have Read, Reviewed and Agreed(Required)

By checking this box, I am indicating that I, the child's parent or guardian, have read, understand, agree and, upon enrollment, can commit to paying the Tuition Rates and Fees as outlined in the Wild Roots’ 2025-2026 Tuition Rates and Fees sheet and based on my selections below.

Selections for Your Child

Select Your Child's Classroom(Required)

Wild Roots classrooms are based on your child's age.

Select Their Typical Schedule(Required)

Note that for the Hazel Room (Kindergarten), the option is solely between 5 Full Days and 5 School Days. Note the tuition as outlined in the rates sheets you may download above.

5 Full Days: 9AM to 6PM, Monday to Friday

3 Full Days: 9AM to 6PM, Monday to Wednesday

2 Full Days: 9AM - 6PM, Thursday and Friday

5 School Days: 9AM - 3PM, Monday to Friday

3 School Days: 9AM - 3PM, Monday to Wednesday

2 School Days: 9AM - 3PM, Thursday and Friday

Select If You Would Like Early Care

This is from 7:30 AM - 8:45 AM. Note the additional tuition as outlined in the rates sheets you may download above.

5 Days: 7:30AM to 8:45AM, Monday to Friday

3 Days: 7:30AM to 8:45AM, Monday to Wednesday

2 Days: 7:30AM to 8:45AM, Thursday and Friday

N/A

Select Wild Roots Additional Programs

Select any additional programs you would like to enroll in. Note the additional rates as outlined in the rates sheets you may download above.

Wild Olympians: Weekly Sports Class (30 min).

Parent Night Out: Last Friday of Each Month (Dinner Provided)

Bella Musica: Private Weekly Music Lessons

N/A

In-House Hot Lunch Program ("Cucina Affamato")

Select the lunch program you would like. Note the additional rates as outlined in the rates sheets you may download above.

5 Days

3 Days

2 Days

Daily (available upon request)

N/A

The Parent Handbook

Review the Parent Handbook

➡️ Click Here to Download the 2025-2026 Parent Handbook.
Please read the entirety of the Parent Handbook. NOTE: You don't have to re-upload it. You can confirm and acknowledge below, and sign at the end of this form.

Confirm You Have Read, Reviewed and Agreed(Required)

By checking this box, I am indicating that as a Wild Roots Holistic Learning Center parent, I have downloaded, read, understood, and agree to adhere to the policies and procedures that are oulined in the Parent Handbook.

Illness and Immunization Policy (page 35 - 39 of Parent Handbook)

Confirm You Have Read, Reviewed and Agreed(Required)

By checking this box, I am indicating that I have read, understand and agree to Wild Roots Holistic Learning Center's policies on illness medication, and immunizations.

Nut-Free Policy Agreement

Review the Nut-Free Policy Agreement

➡️ Click Here to Download and Review the 2025-2026 Nut-Free Policy.
Please read the entirety of the Nut-Free Policy Agreement before acknowledging below.

Confirm You Have Read, Reviewed and Agreed(Required)

By checking this box, I indicate that as a Wild Roots Holistic Learning Center Parent, I will adhere to the policies and procedures that are outlined in the 2025-2026 Nut-Free Policy Agreement.

LineLeader App Usage Agreement

Review the LineLeader App Usage Agreement

➡️ Click Here to Download and Review the 2025-2026 LineLeader App Usage Agreement
Please read the entirety of the LineLeader App Usage Agreement before acknowledging below.

Confirm You Have Read, Reviewed and Agreed(Required)

By checking this box, I indicate that as a Wild Roots Holistic Learning Center Parent, I acknowledge that I have read and agree to abide by the 2025-2026 LineLeader App Usage Policy Outlined in the Agreement.

Infant Service Plan

Is your child an infant (6 weeks - 12 months)(Required)

Yes

2025 - 2026 Infant Service Plan

Click Here to Download. Please fill out the form and upload below.

Accepted file types: pdf, Max. file size: 10 MB.

Additional Programs

Please fill out those applicable below. If your child is not enrolling in additional programs, just proceed to the next portion of this form.

Wild Olympians Registration (Weekly Sports Class)

If you are not enrolling your child in Wild Olympians, you may skip this. It is required for Wild Olympians enrollment.

T-Shirt Size (ie. 4T, Youth Small, etc.)

Acknowledgement

By checking this box, I indicate that as the parent/guardian of the registrant, a minor, acknowledge the possibility of physical injury associated with this outdoor sports activity and release Wild Roots and its staff members from all liability for any injuries sustained while participating in Wild Olympians activities.

Bella Musica (Private Music Lessons Contract and Policies)

➡️ Click Here to Download and Review the 2025-2026 Private Music Lessons Contract and Policies
Please read the entirety of the Contract and Policies before acknowledging below.

Month & Year Beginning Lessons

Which Lessons

Check all that apply.

Piano

Vocals

By checking the box below, you are entering into a contract, agreeing to allow Wild Roots’ music teacher to remove your child from the classroom during their scheduled 30-minute lesson once a week, each week, until this contract is terminated. There, your child will engage in a private music lesson with a music teacher in our music room. Following their lesson, your child will be returned to their classroom immediately to resume classwork. By signing this contract, you are agreeing to a 1- month minimum commitment. Following your 1-month commitment, we simply require a 2-week written notice for change or cancellation of music lessons. We reserve the right to discontinue lessons and cancel this contract any time at our own discretion.

Acknowledgement

By checking this box, I indicate that I agree to enter the contract above.

2025-2026 Scholarship Renewal Application

Is your child currently receiving scholarship benefits from Wild Roots?

If no click next to go to the submission page.

Yes

You are eligible to apply for renewal of your scholarship. Please complete and upload the completed form below.

Scholarship Renewal Form

➡️ Click Here to Download the Scholarship Renewal Form. Please fill out the form and upload below.

Accepted file types: pdf, Max. file size: 10 MB.

Please note that, while we try and grant scholarships to as many of our students as we can, your application does not guarantee approval. Wild Roots reserves the right to approve or deny any applications for scholarship. We will notify you of our decision via email.

Signature

By signing below, I affirm that I am the parent or legal guardian of the student named in this form. I acknowledge that I have personally reviewed and completed all sections of this form, that the information provided is true and correct to the best of my knowledge, and that all documents uploaded and selections made were submitted by me under my authority.

Mother or Guardian 1 Signature(Required)

Use your mouse to sign in the box. (We do not judge computer handwriting!).

Father or Guardian 2 Signature

Use your mouse to sign in the box. (We do not judge computer handwriting!).

Mother Guardian 1 Signature Date (Today's Date)(Required)

MM slash DD slash YYYY

Father Guardian 2 Signature Date (Today's Date)

MM slash DD slash YYYY

Hooray You've Done It!!

Please make sure that you have thoroughly filled out this form. If you have any questions, please email Ms. Lidia at lidia@wildroots.com. Any additional forms can be uploaded below. Once everything is completed, you may click submit below.

File

Max. file size: 512 MB.