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Preschool

Thursday, June 26, 2025 • 30 Sivan 5785

All Day

Register

* First Name of Parent #1:

* Last Name of Parent #1:

* Phone Number of Parent #1:

First Name of Parent #2

Last Name of Parent #2:

Phone Number of Parent #2:

* Address:

* Email:

* Child's First Name:

* Child's Last Name:

* Child's DOB:

* Does the student have allergies?

Does the student receive any of the following:

Occupational TherapySpeech TherapyPhysical Therapy

* I allow permission for the staff to:

Apply sunscreenApply diaper creamTake my child's pictureTake my child on walks around the neighborhood

* Child's Age:

Please select the correct grouping from the options listed. One form per child, please.
Enrollment is based on the age of your child as of June 26, 2025.

Extra Hours:

Early Drop Off 8:00AMEarly Drop Off 8:15AMLate Stay 4:00PM (NO FRIDAY)Late Stay 4:30PM (NO FRIDAY)Late Stay 5:00PM (NO FRIDAY)

* Check here to complete your registration deposit. A non-refundable $25 application fee is required.

Check here to complete your registration deposit. A non-refundable $25 application fee is required.

Total Due:

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Tue, May 6 2025
8 Iyyar 5785

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Tue, May 6 2025 8 Iyyar 5785

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