FHUMC Day School Registration 2023-2024

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Please use this form to register your child for the 2023-24 school year at FHUMC Day School. If you are registering more than one child, we need a separate form for each child. This form is due back by January 20th at 2pm. We will open registration to the community on January 23rd. If you have any questions, please call or email the office - we are happy to help!

Note: Children entering the Bluebirds/Cardinals/Canaries-Eagles classes must be potty trained. To meet this state regulation, your child will need to be in underwear. Thank you!

Email *

Child's First Name *

Child's Last Name *

Name Child Goes By

Child's Date of Birth *

YYYY

Age as of August 15, 2023

Parent 1 Name (Primary Contact) *

Parent 1 Email *

Parent 1 Cell Phone *

Parent 2 Name

Parent 2 Email

Parent 2 Cell Phone

Address (Where child resides)

City/Zip Code

Who does your child reside with?

Mom

Dad

Both Parents

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If child does not live with both parents, is there a unique situation that we should be aware of?

Parent 1's Place of Employment and Phone Number

Parent 2's Place of Employment and Phone Number

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. *

Is your child a returning student?

Yes.

If no, please let us know how you found us on the "Other" line below.

Other:

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Are you a member of a church or faith community? If so, where?

Transportation: To ensure the safety of your child, please make sure that any person authorized to pick up your child is listed as an "Approved Pickup" in Brightwheel. The person(s) designated as your emergency contact must be listed there 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. *

I understand

Does your child have any allergies? If so, what? *

Does your child use an EpiPen?

Yes

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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. *

Yes

Required

Forest Hills UMC Day School 2023-2024 Tuition Rates

Class options are as follows. Please check the days that you would like for your child to attend. Choose their class based on their age on August 15, 2023. Note: "Other" option is only available for Doves; Tuesday/Thursday option is not available for children 4+.

Monday/Wednesday/Friday

Tuesday/Thursday

Full Week

Other

Doves: Under 1

Chickadees: 1 year old

Toucans/Parakeets: 2 years old

Bluebirds/Cardinals/Canaries: 3 years old

Falcons/Owls/Eagles: 4+ years old

If you chose "Other" above, please list days here.

*Please note, we take children's class placements seriously, and many factors such as age, gender, learning style, and personality are taken into consideration.

I understand.

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August tuition and the supply fee are due on June 1, 2023. They are both NON-REFUNDABLE. Additional installments are due by the first of each month beginning in September 2023 and continuing through May 2024. These will be auto-drafted through Brightwheel. *

I understand and accept these terms.

The registration fee is NON-REFUNDABLE and will be due upon confirmation of available spot to guarantee your child a place in the program for Fall 2023 - it will be drafted through Brightwheel for current families; new families should mail/deliver a check to the school. *

I understand and accept these terms.

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. *

I understand and accept these terms.

Forest Hills UMC Day School does not accept immunization exemptions. According to TN State laws and as a private institution we require all students be immunized. We require a current TN Health/Vaccination form on file BEFORE your child can attend school. *

I understand and accept these terms.

Please type your name to represent your signature. *

Today's Date: *

YYYY

A copy of your responses will be emailed to the address you provided.

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