REGISTRATION FORM
LIVING SPRINGS PRESCHOOL
2017-2018 School Year
TO REGISTER:
1. Complete both sides to this form.
2. Attach a $50.00 non-refundable registration/supply fee. Snacks and (lunches where applicable) are included in the tuition fees.
3. Submit both to reserve a placement in a class. Class size is limited.
A complete registration form and payment holds a spot for your child. All remaining paper work and medical information and a copy of your child’s birth certificate must be on file before orientation.
A letter of confirmation will be sent.
TODAYS DATE
STUDENT’S NAME______BIRTHDATE______
NICKNAME (IF ANY)______SEX: (Circle) MALE or FEMALE
HOME ADDRESS______
CITY/STATE______ZIP______
TELEPHONE______EMAIL ___
Father’s CELL# Mother’s CELL #
FATHER’S NAME______MOTHER’S NAME______
MARITAL STATUS OF PARENTS______
OTHER CHILDREN IN THE HOME:
BROTHER______AGE______SISTER______AGE______
BROTHER______AGE______SISTER______AGE______
BROTHER______AGE______SISTER______AGE______
CHURCH AFFILIATION______
Name Address
PREVIOUS PRESCHOOL______
Name Address
ALLERGIES______
(Turn over to choose a class)
I am registering my child for check box(es): Child must be 3 or 4 by Sept. 1
DAY / TIME / Circle Class* / School Year Fee / PROGRAMTTH / 9:00 am-11:30 am / 3 4 / $693 / PRESCHOOL
MWF / 9:00 am-11:30 am / 3 4 / $999 / PRESCHOOL
TTH / 8:00 am-3:00 pm / 3 4 / $1566 / PRESCHOOL AND DAY CARE
MWF / 8:00 am-3:00 pm / 3 4 / $2385 / PRESCHOOL AND DAY CARE
TTH / 8:00 am -5:00 pm / 3 4 * / $2061 / PRESCHOOL DAY CARE
MWF / 8:00 am -5:00 pm / 3 4* / $3105 / PRESCHOOL DAYCARE
TTH / 9:00 am-3:00 pm / X 4 / $1476 / PRESCHOOL
MWF / 9:00 am-3:00 pm / X 4 / $2250 / PRESCHOOL
You must check 2 boxes for your child to be enrolled 5 days per week. Add the 2 fees together for the total tuition fee.
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POLICY FORM
LIVING SPRINGS PRESCHOOL
I have read the Living Springs Preschool Parent Handbook which includes the school’s Guidance and Discipline policies and agree to it. I understand that I am responsible for the payment of tuition as outlined.
______
Parent Signature Date
______
Parent Signature Date
NOTE: This agreement may be voided by written notice anytime within two weeks of the date the child starts school. Should it become apparent that a child is not adjusting and a deferment is recommended, the REGISTRATION FEE and TWO WEEKS’ TUITION will be retained by the school and any prepaid balance refunded to the parents.
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OFFICE USE ONLY