Registration Form

* Required field.

Child’s Name:*
Nickname:
Male Female
Date of Application
Street Address:*
City:*
State:*
Zip:*
Birthdate:*
Age:*
Father
Name:
Phone:
Address:
Cell Phone:
Place of Employment:
Email Address:
Mother
Name:
Phone:
Address:
Cell Phone:
Place of Employment:
Email Address:
General Information
Any Allergies:
Child's interests:
Does your child attend another school/daycare?
Will your child be attending kindergarten the following year after preschool? Yes No

---

We offer a 9-month (September to May) program.
Tuition will be divided based on your selected payment plan:*

3 Year Olds: $729/yr. 9 mo: $81 Sep-May (must be 3 by Aug. 1st) Tues & Thurs 8:45-11:15 a.m.

4 Year Olds: $909/yr. 9 mo: $101 Sept-May (must be 4 by Aug. 1st) M-W-F 8:45-11:15 a.m.

Prekindergarten: $1,179/yr. 9 mo:$131 Sept-May (must be goign to K following year) M-T-W-Th 12:15-3 p.m.

*A $40 non-refundable deposit is due upon registration.*

For further information, call: Becky Hinch, Director, 740-397-9000, ext. 3735