Waleska UMC Preschool Registration Form

Waleska UMC Preschool Registration Form
Child’s Full Name*
Child’s Age as of September 1, 2025*
Name Called*
Mother’s Name*
Father’s Name*
Child Lives With*
Mother’s Employer*
Father’s Employer*
Sibling(s) name(s) and ages
Mother’s Address*
City*
Zip Code*
Father’s Address (if different than above)
City
Zip Code
Mother’s Email Address*
Mother’s Primary Phone Number*
Do you receive Text at this number?*

YesNo
Father’s Email Address*
Father’s Primary Phone Number*
Do you receive Text at this number?*

YesNo
Student's Birthday*
Student's Gender*

MaleFemale
Please Select Your Child’s Class*

4 Year Olds- Mon-Thu (9-1pm) ($245/month)3 Year Olds- Tue, Wed & Thu (9-12pm) ($210/month)2 Year Olds- Tue & Thu (9-12pm) ($180/month)Young 2s- Mon & Wed (9-12pm) ($180/month)PMO-Tuesday (9-12pm) ($100/month)
Please list any allergies or medical conditions your child may have:*
Please list any medications your child takes regularly:*
General Registration Policies

The following forms and documents must be completed and on file by the first day of school: Preschool Registration Form (this one); *Valid Certificate of Immunization Form 3231( will be acquired by the preschool office through the State Agency for Immunizations) or DPH Waiver Form 2208; Emergency Information Form and Parent-Program Agreement. These forms will be sent to you via your Brightwheel Account which is formed after an email invite from Preschool. You may pay registration online at that time.;
Registration Fee and Withdrawal

The registration fee of one month’s tuition is non-refundable after May 31st and the parent is asked to give one month’s notice if your child must withdraw prior to the end of the school year. Registration Fee is $245 for 4 year old classes, $210 for 3 year old classes, $180 for 2 year old classes and $100 for PMO
By signature below, I agree to pay the cost of preschool for the 2025-2026 school year in 9 equal tuition payments of $ on the first week of August through April with no payment due in May. However, if my child registers and is accepted into the program mid-month and/or after the school year has begun, I will be responsible for a partial tuition payment for the month of May. I have been advised and understand that the program is not licensed nor required to be licensed by the state of Georgia. Waleska UMC carries liability insurance. Acceptance of this enrollment agreement and the registration fee assures your child a place in the Preschool on the first day of the school year 2025-2026.
Signature

Clear
Date

MonthDayYear
Date
We occasionally take pictures

of the kids in action with the materials

or doing other activities for our website/Brightwheel.

We use these to keep parents

up to date on the happenings at school.
Please click yes if you WILL give permission to have photographs of your child taken*

YesNoOnly for my personal update/emails etc.
How did you find us?*

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If you were referred by a friend please let us know who, so we can thank them!
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Waleska UMC Preschool Registration Form

General Registration Policies

Registration Fee and Withdrawal