Wild Roots RSM Pre-Admission Intent Form This Pre-Admission Intent Form confirms your interest in moving forward with enrollment at Wild Roots Holistic Learning Center. Once submitted, you will be provided with access to the full admissions packet for completion. Enrollment InformationNumber of Children to be EnrolledChild's Name(Required) First Last Age Child 2's Name(Required) First Last Age Child 3's Name(Required) First Last Age Child 4's Name(Required) First Last Age Child 5's Name(Required) First Last Age Parent/Guardian InformationParent/Guardian Name(Required) First Last Parent/Guardian 1 Email Address(Required) Parent/Guardian 1 Phone(Required)Is there a secondary parent/guardian? Yes No Parent/Guardian 2 Name(Required) First Last Parent/Guardian 2 Email Address(Required) Parent/Guardian 2 Phone(Required)After submitting this form, you will receive an email at the address you provided. This email will include instructions on how to complete your full admissions packet. Please review everything carefully, and don't hesitate to reach out if any questions arise. We’re here to help! Δ