AGAPE Registration 2021-2022
Please complete all required fields below. Your application will be complete when this form is submitted and AGAPE has received your application fee of $75/new student or $50/returning student.

All students must be the required age for the class by September 30, 2021 with the exception of the 5-day Pre-Kindergarten. 5-day students must be 5-years-old by April 30, 2022.


Classes meet on the following weekdays:

Twos: 2 day option-Monday & Wednesday
3 day option- Monday, Tuesday, Wednesday

Threes: 3 day option- Monday, Wednesday & Friday
4 day option- Monday, Tuesday, Wednesday, & Friday

Fours: 3 day option - Monday, Wednesday & Friday
4 day option-Monday, Tuesday, Wednesday & Friday
5 day option

Kindergarten: Monday through Friday

My child is a *
Child's First Name *
Child's Middle Name
Child's Last Name *
All email addresses to which you want communication to be sent *
First Choice Class *
Second Choice Class- if first choice is not available *
Sex *
Date of Birth *
MM
/
DD
/
YYYY
email
Home Phone
Allergies (food, seasonal and environmental)
Home Street Address *
City *
Zip Code *
Mother's First Name *
Mother's Last Name *
Mother's Employer
Mother's Cell Phone *
Mother's Work Phone
Father's First Name *
Father's Last Name *
Father's Employer
Father's Cell Phone *
Father's Work Phone
Special Needs
*
Untitled Title
Submit
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This form was created inside of Gayton Baptist Church. Report Abuse