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Mount Moriah Preschool Registration Form
Please complete the form to register your child for preschool. Payment needs to be received as well to hold your child's spot. A separate form is needed for each child.
Child's Name *
Your answer
Gender *
Street Address *
Your answer
City, State, Zip Code *
Your answer
Home Phone/Cell Phone *
Give the best number to reach you.
Your answer
Email Address *
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Child's Age as of August 31, 2019 *
Your answer
Potty Trained? *
Required
Monthly Tuition Rates *
MMBC or Sibling Discount
$5.00 off 2-day Tuition $10.00 off 3-day Tuition $15.00 off 4-day Tuition $20.00 off 5-day Tuition
Registration fee of $100 after June 1, 2019 *
Your child's non-refundable registration fee must accompany this form. This registration fee will be returned to you in the event there is no space available for your child. Space is on a first-come first-serve basis. Checks are to be made payable to “Mount Moriah Preschool”.
Required
Any details/questions
Your answer
Signature *
Your answer
Submit
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