FHUMC Day School Registration 2020/2021
Please use this form to register your child for the 2020/2021 school year at FHUMC Day School. If you are registering more than one child, you need to fill out a form for each child. This form is due on Friday, January 17. We will open registration to the community on Wednesday, January 22. If you have any questions, please stop by the office - we are happy to help!

Children entering the Bluebirds-Eagles classes MUST be potty trained. Pull-ups are NOT ALLOWED in these classes.
Full Name of Child *
Your answer
Name Child Prefers
Your answer
Child's Date of Birth *
Your answer
Age as of August 15, 2020
Your answer
Mother's Name
Your answer
Father's Name
Your answer
Address (Where child resides)
Your answer
City/Zip Code
Your answer
Mother's Email
Your answer
Father's Email
Your answer
Mother's Cell Phone
Your answer
Father's Cell Phone
Your answer
Mother's Place of Employment and Phone Number
Your answer
Father's Place of Employment and Phone Number
Your answer
How did you hear about our school?
Your answer
Are you a member of a church or faith community? If so, where?
Your answer
Transportation: To ensure the safety of your child, please list other adults to whom your child may be released or who are authorized to provide transportation for your child. The person(s) designated as your emergency contact must be listed here also. At no time will a child be released to anyone, including a parent or other designated person, whose behavior may place the child in immediate risk. *
Your answer
Emergency Information: Please list someone other than a parent, who is authorized to make decisions, should we not be able to reach you. This person must be local (within 30 minutes of the school). Please include their name, phone number, and address. *
Your answer
Physician Information: Name, Office Phone Number, Address, City/Zip
Your answer
Does your child have any allergies? If so, what? *
Your answer
Does your child use an EpiPen?
I hereby authorize Forest Hills UMC Day School, to whose care the above named minor has been entrusted, to consent to an x-ray examination, anesthetic, medical or surgical diagnosis or treatment, and hospital care to be rendered to said minor under the general or special supervision and upon the advice of a physician and surgeon licensed under the provisions or the Medical Practice Act, or to consent to an x-ray examination, anesthetic, dental or surgical diagnosis, or treatment, and hospital care to be rendered to said minor by a dentist licensed under the provisions of the Dental Practice Act. I furthermore authorize Forest Hills UMC Day School to have the above named minor released into the custody of its representative, should hospital care no longer be required. This form will be used only in an extreme emergency, when said parents or guardians cannot be, or are unable to be contacted. *
Required
2020/2021 Tuition Rates
Class options are as follows. Please check the day(s) that you would like for your child to attend. Choose their class based on their age on August 15, 2020.
Monday
Tuesday
Wednesday
Thursday
Friday
Doves: 6 weeks-11 months
Chickadees: 12 months - 23 months (Must choose at least 2 days!)
Toucans: 24 - 30 months (MWF, TR, or 5 days)
Bluebirds/Cardinals: 31-47 months (MWF, TR, or 5 days)
Falcons/Owls: 48 - 59 months (MWF or 5 days)
Eagles: 60 months and up (MWF or 5 days)
*Please note, we take children's class placements seriously, and many factors such as age, gender, learning style, and personality are taken into consideration.
The first installment and supply fee are due on or before June 1, 2020. They are both NON-REFUNDABLE. Additional installments are due by the first of each month beginning in September 2020 and continuing until May 2021. You will be billed for these through BrightWheel. *
The registration fee is NON-REFUNDABLE and will be billed on January 17, 2020 on Brightwheel to guarantee your child a place in the program for Fall 2020. *
Forest Hills UMC Day School reserves the right to cancel or alter any classes that do not meet minimum ratios. I have read and understand the above pricing and policies and I acknowledge that I have toured the facility. *
Please type your name to represent your signature. *
Your answer
Today's Date: *
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