Grace Beginnings Preschool Registration Form
2020-2021 School Year
* Required
Email address
*
Your email
Student Name:
*
Your answer
Student Address:
*
Your answer
Student Birth Date:
*
MM
/
DD
/
YYYY
Desired Class:
*
T-TH 3 Yr. old AM Session 9:00-11:30 a.m. (Must be 33 months of age and be developmentally ready.)
T-TH 3 Yr. old PM Session 12:30- 3:00 p.m. (Must be 33 months of age and be developmentally ready.)
M-W-F 4 Yr. old AM Session 9:00-11:30 am (Must be 45 months of age and be developmentally ready.)
M-W-F 4 Yr. old PM Session 12:30-3:00 p.m. (Must be 45 months of age and be developmentally ready.)
Required
Home Phone:
*
Your answer
Mother's Name:
Your answer
Address (if different from students):
Your answer
Mom Cell:
Your answer
Mom Email:
Your answer
Mother's Occupation:
Your answer
Work Phone Number:
Your answer
Father's Name:
Your answer
Dad Cell:
Your answer
Address (if different from students):
Your answer
Occupation:
Your answer
Work Phone Number:
Your answer
Please List Siblings (Names, Ages):
Your answer
Are you interested in more information about Grace Lutheran Church?
*
Yes
No
Other:
Does your child have any allergies?(If yes, please list)
Your answer
Does your child have any medical conditions we should be aware of? (if yes, please explain)
Your answer
Any additional information we should be aware of?
Your answer
Would you like an invoice emailed to you for the $50.00 (non refundable) registration fee to be paid online with a debit/ credit card? (your child will not be registered until the fee in paid in full)
*
Yes, Send me an invoice
No, I will stop into the preschool office to pay the registration fee in person
Send me a copy of my responses.
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