Bethlehem Preschool Enrollment Form
If you are ready to enroll your child, complete the form below to secure a spot.
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Child's Name?
Child's Date of Birth?
MM
/
DD
/
YYYY
Mother's Name?
Father's Name?
Family Email?
Home Address?
Phone Number?
What would you like to enroll your child in?
My child will need before school care on the following days:  (please note that we open at 7:45 am)
My child will need after school care on the following days:  (please note that we close at 5:30 pm)
If attending after school care, please indicate your approximate daily pick up times. 
Registration fee agreement: I understand that I am responsible for the $50 registration fee within 14 days of receiving it.  (not applicable to JAM Session)
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