REGISTRATION 2018/2019 | Messiah Lutheran Church

Preschool Online Registration

We are thrilled to have your child(ren) in Preschool with us this year! Please complete the information below to register your child for the 2018-2019 school year. If a question that is required does not apply to you please simply type “None”.

A $50 non refundable registration fee is due to make the application/registration complete Please make checks out to Messiah Preschool. Messiah Preschool NOW accepts Visa & MasterCard payments. If you would like to pay your registration fee with a Visa or MasterCard, please contact our Director, Annie Bilski

Enter Child's First, Middle and Last name

Child's Nickname

Child's Date of Birth

Is Your Child Baptized?

Yes

Baptism Birthday

Address

Address

City

Postal Code

State

Primary Email

Secondary Email

Mother's Full Name

Mother's Occupation

Mother's Cell Phone Number

Mother's Work Phone

Father's Full Name

Father's Occupation

Father's Phone Number

Father's Work Phone

Please describe your child(ren)'s current living situation (example: Carter lives at home with both parents, sister and brother. OR Carter lives with mom & step-dad during the week, dad on weekends)

In the event of an emergency and the parent's are unable to be reached, please list TWO (2) people, WHO ARE NOT PARENTS, who should be contacted. Please be sure that these people have permission to transport your child. The following list will be considered permission from you to have these people pick up your child from preschool. **THE INDIVIDUALS CANNOT BE PARENTS, PLEASE LIST 2 ADULTS WHO ARE NOT PARENTS

Name of Emergency Contact #1 CANNOT be a Parent

Relationship to Child

Address of Emergency Contact #1

Address

City

Postal Code

State

Phone number(s) of emergency contact #1

Name of Emergency Contact #2 CANNOT be a Parent

Relationship to Child

Address of Emergency Contact #2

Address

City

Postal Code

State

Phone number(s) of emergency contact #2

Will your child(ren) be attending daycare before or after school?

Yes

Name, Address and Phone Number for your daycare provider. This information will provide them with the permission to pick up your child(ren) from preschool.

Child's Physician's Name, Location & Phone Number

Dentist's Name, Location & Phone Number

Names of other children in the household, Ages and relationship to student. Please separate with a comma

Church Membership & Location. If you do not attend a church or if you're not a member please type

Class Options:
Monday - Friday Half Day (9am - 11:30am) Full Day (9am - 3:30pm) Extended Days (7:30am - 9am) &/or (3:30pm - 5:30pm) Typical Classes Are: Monday/Wednesday/Friday Tuesday/Thursday Monday/Tuesday/Wednesday/Thursday/Friday A minimum of 2 days per week is required for registration.

Enrollment into a classroom is based upon the child's date of birth. Upon review, the director has the authority to place a child into a classroom that the teaching staff and director feels is appropriate. A review of all applications will occur prior to the school year and should a discrepancy be noted parents will be contacted.

Each class session has a minimum enrollment of 8 and a maximum enrollment of 15 in our Preschool (3/4 year olds) classroom & 20 in our PreKinders (4/5 year olds) classroom

A registration fee of $50.00 is required to make this application/registration complete. This fee is not refundable nor does it apply to tuition. Payments can be made in the form of checks, money orders, Visa or MasterCard. If you would like to pay with a Visa or MasterCard please allow 5 business days to process your registration. Make a note in the comment section and our Director will give you a call!