Application for Enrollment

Application for Enrollment

NON-REFUNDABLE registration fee of $100 for the first child, $50 for the second child is due at time of enrollment. This can be mailed in or dropped off at the office. St. Christopher's Episcopal Preschool 2800 Trimmier Rd. Killeen, TX 76542
Registration for:

School Year 2021/2022
Student Name

First Name Middle Name Last Name
NICKNAME:
Date of birth: *

Month Day Year
Date
Age: (as of Sept. 1, 2021)
Gender:
ARE THERE ANY ALLERGIES, SPECIAL FOOD CONSIDERATIONS, OR MEDICAL CONDITIONS? Please also include any outside therapies or services, i.e. speech therapy, physical therapy, occupational therapy.
Please list:
If you would like to upload your child's immunization and health assessment record, please do here.

Browse Files
Immunization Record and/or health assessment form Cancel of
Name of Physician

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
I AUTHORIZE ST. CHRISTOPHER'S EPISCOPAL PRESCHOOL TO OBTAIN MEDICAL CARE AND TO TRANSPORT MY CHILD FOR EMERGENCY MEDICAL TREATMENT.
Signature

Clear

Registration for another student
Registration for:

School Year 2021/2022
Student Name

First Name Middle Name Last Name
NICKNAME:
Date of birth:

Month Day Year
Date
Age: (as of Sept. 1, 2021)
Gender:
ARE THERE ANY ALLERGIES, SPECIAL FOOD CONSIDERATIONS, OR MEDICAL CONDITIONS? Please also include any outside therapies or services, i.e. speech therapy, physical therapy, occupational therapy.
Please list:
If you would like to upload your child's immunization and health assessment record, please do here.

Browse Files
Immunization Record and/or health assessment form Cancel of
Name of Physician

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
I AUTHORIZE ST. CHRISTOPHER'S EPISCOPAL PRESCHOOL TO OBTAIN MEDICAL CARE AND TO TRANSPORT MY CHILD FOR EMERGENCY MEDICAL TREATMENT.
Signature

Clear

Parent Name:

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number

Area Code Phone Number
Email
example@example.com
Employer:
Parent Name:

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number

Area Code Phone Number
Email
example@example.com
Employer:
Signature:

Clear
YOUR DOB:

Month Day Year
Date

***EMERGENCY INFORMATION***

In the event parents/guardians are not available, I authorize the school to contact or release my child to the following people: This information is required by the state of Texas. YOUR EMERGENCY CONTACTS CANNOT BE LISTED UNDER PARENT INFORMATION AND MUST BE WITHIN 25 MILES.
1. Name

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number

Area Code Phone Number
2. Name

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number

Area Code Phone Number
3. Name

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number

Area Code Phone Number
In the event someone needs to pick our child up from school. Who has permission?
Transport Permission
PLEASE REMEMBER TO KEEP ALL EMERGENCY INFORMATION CURRENT.

Are you interested in the before or after school program?
This does not apply to Summer School Sessions. Before and after care only available during the school year.
Siblings and their ages:
Comments:
Any questions or comments
Photo/Social Media Consent Form

St. Christopher's Episcopal Preschool Photo/Social Media Consent Form
Dear Parent/Guardian,

During the school year, we at St. Christopher's Episcopal Preschool, take photographs and videos of students during their activities within the premises. Some photographs may captue your child's participation, directly or indirectly. In this regard, we seek your consent for the publishing or use of photos which your child may be included on our website, Facebook page, school program videos, or through promotion of our school.The photos and videos may be used for bulletin boards, marketing or advertising, and/or marketing updates posted via the facebook page, website, and/or within the walls of the premises. Should you decided to take back your authorization later on, you may do so by writing to us.
Photo Consent

Yes, I consent to my children's photo being used. No, I do not consent to my children's photo being used.
St. Christopher's Episcopal Preschool Handbook Consent Form
Parents and Guardians,

Our student handbook is available online. Click on the admissions tab and then school forms. You can find it labeled St. Christopher's Episcopal Preschool Handbook e-signature Consent form. It can also be found under the admissions tab, click on Parent Handbook.

We ask that all families review our policies and procedures. There is a lot of information contained in our handbook from our philosophy, our admission and registration, fees, medical and safety questions, special events at school, and also a list of items your child will need on the first day school.

If you had read and understand the guidelines for St. Christopher's Episcopal Preschool and Kindergarten, please check the box yes. If not please find the handbook online and sign or please contact us with any questions.
I understand and agree that clicking yes in the Handbook Consent box that it will act as my signature and will be valid that I have read and understand St. Christopher's Episcopal Preschool Handbook.
Handbook Consent

Yes, I have read and understand the handbook.
SIGNATURE:

Clear
Today's Date

Month Day Year
Date
Should be Empty:

Application for Enrollment

***EMERGENCY INFORMATION***

Photo/Social Media Consent Form

St. Christopher's Episcopal Preschool Handbook Consent Form

EMERGENCY INFORMATION