13145 S. Blackbob Rd., Olathe KS 66062 Tel: 913-780-6889 Fax: 913-780-0602
Please return completed enrollment form with a non-refundable registration fee of $60.00.
There is a $20 Activity/Resource Fee that will be collected with your first month’s tuition (waived for MDO).
This fee covers special events, Bible binders, and Bible sheets during the year.
Student Information
Child’s Name ______Male/ Female______
First Middle Last
Preferred Name or Nickname ______Birthdate ______
Month Day Year
Home Address ______City ______State _____ Zip ______
Primary Phone ______Secondary Phone ______
Primary E-mail ______Secondary E-mail ______
Parent Information
Father’s Full Name ______Mother’s Full Name______
First Last First Last
Home Address (If Different from Student) Home Address (If Different from Student)
______
______
______
Business/Employer ______Business/Employer ______
E-mail ______E-mail ______
Cell Phone ______Cell Phone ______
With Whom Does the Student Live? ______
Do you have a faith community? Yes ______No ______If yes, name ______
Does the child have any allergies? ____Yes ____No If yes, please List______
Are there any health concerns? _____ Yes _____ No If yes, please explain ______
______
Does the student have any specialized needs? _____ Yes _____ No
If yes, please describe them ______
______
Please share your child’s strengths, talents and weaknesses. ______
______
How did you hear about Beautiful Savior Lutheran Preschool? ______
Emergency Contacts(If parent(s) cannot be reached):
Name ______Phone ______
Name ______Phone ______
Authorized Pickup(Persons authorized to pick up this child other than parents.)
Name ______Phone ______Relationship ______
Name ______Phone ______Relationship ______
Permission to Participate in School Activities
I hereby grant permission for ______to use all play equipment and participate in all activities of the school; participate in supervised walks and other activities away from the building premises; and be included in pictures connected with the school program which may be shared with other Preschool families or on our Preschool website.
Signed ______Relationship ______Date ______
The following forms must be completed and returned prior to the first day of class:
- Enrollment Form and $60 Registration Fee
- Emergency Authorization (blue form)
- Health Form signed by physician with a copy of your child’s vaccination record (pink form)
Student’s Name: ______
Classes are filled on a first come basis. Enroll early to get your preferred session(s).
Half day 8:30 am - 11:15 am M or F $92/mon T or W or Th $96/mon/1x per wk
Full day 8:30 am - 3:00 pm $160/mon/1x per wk $310/mon for 2x per wk
HALF DAY _____ Monday _____Tuesday _____Wednesday _____Thursday
FULL DAY _____ Monday _____Tuesday _____Wednesday _____Thursday
YOUNG THREES Must be 2 ½ (30 months) years old.
_____Monday/Wednesday 8:30-11:15 am ____$140/mon ____w/ Discovery Friday $175/mon
_____Tuesday/Thursday 8:30-11:15 am ____$145/mon ____w/ Discovery Friday $180/mon
THREES Must be 3 by August 31st and potty-trained.
_____Monday/Wednesday 8:30-11:15 am ____$140/mon ____w/ Discovery Friday $175/mon
_____Tuesday/Thursday 8:30-11:15 am ____$145/mon ____w/ Discovery Friday $180/mon
DISCOVERY FRIDAY Must be 2 ½ (30 months) – 4 years old.
_____ 8:30-11:15 am $65/month
FOURS/PRE-K Must be 4 by August 31st and potty-trained.
_____Monday/Wednesday/Friday 8:30-11:15 am$170/month_____ Tuesday/Thursday/Friday 8:30-11:15 am$175/month
Older PRE-K Recommended age – 5 by March 1st. Must be potty-trained.
_____Monday/Tuesday/Wednesday/Thursday12:15-3:00 pm$235/monthMULTI-AGE 3-5 yrs. Must be 3 by August 31st and potty-trained.
Children must bring a sack lunch for the all day program.
_____ Monday –Friday all day8:30 am - 3:00 pm$683/month
_____Monday – Friday am8:30 am – 11:15 am$290/month
_____ Any 4 mornings8:30 am – 11:15 am$235/month
_____ Any 3 mornings8:30 am – 11:15 am$170/month w/Mondays, or $175
_____ Any 2 mornings8:30 am – 11:15 am$140/month w/Mondays, or $145
EXTENDED DAY: 11:15 am-3:00 pm
$80/mon 1x wk; $155/mon 2x wk; $210/mon 3x wk; $275/mon 4x wk
_____ Monday _____Tuesday _____Wednesday _____Thursday _____Friday
AFTER SCHOOL CARE: 3:00-4:00 pm
$93/ mon 5x wk; $55/mon 3x wk; $37/mon 2x wk
_____ Monday _____Tuesday _____Wednesday _____Thursday _____Friday