SGBA 2025-26 Application

Tuition - Standard Hours 8:30am-12pm

Preschool 3 Day Option (Tues, Wed, Thurs) Registration Fee: $200 Monthly Tuition: $175	Preschool 5 Day Option (Mon-Fri) Registration Fee: $200 Monthly Tuition: $245	Bridge Program (Mon-Fri) Registration Fee: $200 Monthly Tuition: $370
Infant - 24 Months 3 Day Option (Tues, Wed, Thurs) Registration Fee: $200 Monthly Tuition: $200	Infant - 24 Months 5 Day Option (Mon-Fri) Registration Fee: $200 Monthly Tuition: $270

Lunch Bunch Extended Stay Program
Lunch Bunch is our extended stay program which allows children to stay later than regular preschool hours three days a week. The children bring their lunches and enjoy a time of free play in the classroom, on the playground, or in the gym. Children ages 2 and under will have a nap/rest time.

Children will stay until 2:00pm three days a week for an additional fee.

Lunch Bunch Days: Tue, Wed, & Thur.
Monthly Tuition: $100/Month

Monthly sign up and payment is due at the first of the month. Your spot will not be reserved until your payment has been received.

** Bridge Students will stay for Lunch Bunch on Tue, Wed, and Thur. Their lunch bunch fee is included in the monthly tuition.*

Drop-ins
The drop-in rate is $30 a day.
Lunch Bunch drop-in rate is $20 a day.
Arrangements must be made at least one day in advance and payment must be made at time of reservation. Drop-ins are only taken if space allows.

Tuition is due the first week of school. All other tuition payments are due the FIRST day on the month. There will be no rate adjustments for absenteeism, holidays, or bad weather days.

REGISTRATION FEE MUST ACCOMPANY YOUR APPLICATION FOR YOUR CHILD TO BE UNROLLED. THIS FEE IS NON-REFUNDABLE.

*ALL FEES ARE SUBJECT TO CHANGE WITH A TWO-WEEK NOTICE**

Please select the program you are registering your child for:*

8 weeks - 12 months (3 day option)8 weeks - 12 months (5 day options)18 months (3 day option)18 months (5 day option)2 years old (3 day option)2 years old (5 day option)3 years old (3 day option)3 years old (5 day option)4 years old (5 day option only)Bridge (5 day option only))
Will your child be staying for Lunch Bunch on Tuesday, Wednesday, and Thursday from 12-2? -Bridge is required to stay for Lunch Bunch and is included in the final price -Lunch Bunch is offered at an additional price*

YesNo
Child's Name*

First NameLast Name
Child's Date of Birth*

MonthDayYear
Date
Please select one:*

MaleFemale
Age on September 20th, 2025*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Signature of person completing application:*

Clear
Mother's Name*

First NameLast Name
Occupation
Employer
Cell Phone*
Please enter a valid phone number.
Work Number
Please enter a valid phone number.
Email*
example@example.com
Are you a member of SGBC?*

YesNo
If no, do you have a home church?*

YesNo
Best method of contacting parent?*

CallText
Does the child live with this parent?*

YesNo
If no, is this parent allowed to pick the child up from school?*

YesNo
Father's Name*

First NameLast Name
Occupation
Employer
Cell Phone*
Please enter a valid phone number.
Work Number
Please enter a valid phone number.
Email*
example@example.com
Are you a member of SGBC?*

YesNo
If no, do you have a home church?*

YesNo
Best method of contacting parent?*

CallText
Does the child live with this parent?*

YesNo
If no, is this parent allowed to pick the child up from school?*

YesNo
Is there a court ordered custody agreement?*

YesNo
If yes, please attach a copy of the agreement for our files.

Cancelof
Names of other children in the family:
Name:

First NameLast Name
Age
Name:

First NameLast Name
Age
Name:

First NameLast Name
Age
Name:

First NameLast Name
Age
Pick Up List

Please list people (other than parent) who have permission to pick up the child from school:
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Relationship to the child*
Nickname (if applicable)*
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship to the child
Nickname (if applicable)
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship to the child
Nickname (if applicable)
Medical Information
Physician's Name:
Phone Number
Please enter a valid phone number.
Food Allergies:
Seasonal Allergies:
Physical Limitations:
Hearing/Vision/Speech Difficulties
Any other special needs/conditions that we should be aware of?
** You must submit a copy of up to date immunizaztion records before your child can attend preschool. **

Consent for Medical Care
I understand the staff at Summer Grove Baptist Academy will exercise all reasonable care in supervising my child. However, the staff and Summer Grove Baptist Church cannot be held responsible for accidents which may occur. In the event that my child should need emergency medical care/treatment, and I nor my emergency contacts can be reached, I hereby give permission that 911 may be called and medical services rendered. I understand that I will be finacially responsible for any medical care given. I also authorize my child to be transportaed by car or emergency vehical if need be.
Parent/Guardian Name:*

First NameLast Name
Parent/Guardian Signature:*

Clear
Today's Date:*

MonthDayYear
Emergency contact if parents cannot be reached:
Name*

First NameLast Name
Phone Number:*
Please enter a valid phone number.
Relation to child:*
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Relation to child:
Should be Empty: