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CCNS Student Registration Form 2024-2025
2024-2025 CCNS Family Registration
Please complete all required sections, select your class preference & submit your $55 non-refundable registration fee.
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* Indicates required question
Child Last Name
*
Your answer
Child First Name
*
Your answer
Name to be Used in School
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Gender
*
Male
Female
Prefer not to say
2024-2025 Class Descriptions
Primary Classroom
*
AM Pre-K
PM Pre-K
Young 4's
3's 3-Day
3's 2-Day
Young 3's
Wee PAL Wednesday
Wee PAL Tuesday
Wee PAL Friday
Kindergarten Enrichment (4-Day M-R)
Kindergarten Enrichment (3-Day TWR)
Registration Type
*
New Family
In-House Family (Your child is currently enrolled in a Pre-School Class for 2023-2024)
Wee PAL/KE Family (Your child is currently enrolled in Wee PALs or Kindergarten Enrichment)
Alumni Family
Parent/Guardian #1 Full Name
*
Your answer
Parent/Guardian #1 Email Address
*
Your answer
Parent/Guardian #2 Full Name
Your answer
Parent/Guardian #2 Email Address
Your answer
Street Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Primary Phone Number
*
Your answer
Secondary Phone Number
*
Your answer
Are you registering more than 1 child? ** (If you are registering more than 1 child, please fill out a registration form for each child and submit a $55 registration fee with each form.)
*
Yes
No
Sibling Name and Birthdate
Your answer
Sibling Name and Birthdate
Your answer
Sibling Name and Birthdate
Your answer
Future Elementary School
*
Your answer
Your submission of this form and payment of the $55 non-refundable registration fee indicates that you understand that completing this form does not guarantee your child a spot in your preferred class. Children will be placed in classes according to the CCNS registration priority policies.
*
I agree and I have paid my $55 registration fee (plus 3% convenience charge) at:
https://pl.mxmerchant.com/mxcustomer/d/0514d702-4384-40fe-9e70-e9b0c980a03a/v3
I will submit my payment ASAP by check or cash. I understand that my form will not be counted until my registration fee is received.
Please subtract my registration from my ACH account. I understand that my form will not be counted until my registration fee is received.
Required
How did you hear about CCNS?
Your answer
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