Nursery School Registration Form Information About the ChildChild's First Name *Child's Middle NameChild's Last Name *Child's Home Address *Apartment, suite, etcCity *State *ZIP Code *Child's Date of Birth *School District where Child Resides *Has the child previously attended a school? *NoYesWhere has the child attended school? *Does the child receive special services? *NoYesPlease tell us about the special services the child receives. *Does the child have any allergies? *NoYesPlease tell us about the child's allergy concerns. *Does the child have any other concerns we need to be aware of? *NoYesei: Physical or emotional concerns that will help the teacher to understanding the child.Please tell us about the child's additional concerns. *Does the child have siblings? *NoYesPlease tell us about the child's siblings. *Information About the Child's Guardian(s)Add additional guardians by clicking 'Add Guardian' below.Parent/Guardian's First Name *Parent/Guardian's Middle NameParent/Guardian's Last Name *Parent/Guardian's Email Address *Parent/Guardian's Phone # *Parent/Guardian's Occupation *Is the Parent/Guardian's Home Address Different than the Child's?YesNoParent/Guardian's Home Address *Apartment, suite, etcCity *State *ZIP Code *Is Parent/Guardian a member of Zion Mennonite Church?YesNoConsent & VerificationPhotography Release *I give permission for my child to be photographed for informal pictures. I know this picture will be displayed within the classroom, hallways, used in slide shows and/or posted on our website or social media; I know names WILL NOT be used to identify any students at any time.I DO NOT give permission for my child to be photographed for informal pictures.The child is potty trained. *All children must be potty-trained before beginning school!Registration InformationI am registering the child for: *Preschool (2 days per week)Tuesday & Thursday9:00-11:30 a.m$190/monthPre-Kindergarten (3 days per week)Monday, Wednesday & Friday9:00-12:00 p.m.$220/monthPre-Kindergarten (5 days per week)Monday, Tuesday, Wednesday, Thursday, Friday9:00-12:00 p.m.$320/monthMy Toddler & MeWednesday9:00 to 10:30 a.m.$???Afternoon AdventuresMonday, Tuesday, Wednesday12:00 - 2:30 p.m.$???Parent/Guardian SignatureUse your mouse, trackpad or finger to sign here.Your browser does not support e-Signature field. Send MessageSave & Continue Later
