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Preschool Registration Form
Child\'s Legal Name (ex Matthew John Smith) (*)
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Common Name (ex. Matt) (*)
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Date of Birth (*)
Gender (*)
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Year beginning Kindergarten (*)
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Parents Name (*)
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Address (*)
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City/State/Zip (*)
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Home Church (*)
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Home Phone (*)
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Work Phone
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Cell Phone
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Email (*)
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Please check:


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Please check your first choice: (*)



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A $50 registration fee is due with this application. This registration fee is non-refundable, unless you are placed.
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