Registration Form 2023-2024
Today's Date
/
Month
/
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
CHILD INFORMATION
Child's Name
*
First Name
Last Name
Class Assignment(s)
Age
*
Enter age in years
Birth date
*
/
Month
/
Day
Year
This information is used to confirm the appropriate class assignment for your child.
DOB Value
Gender
*
Female
Male
My child is fully immunized per Washington State Department of Health recommendations.
(Requirement waived for MEDICAL EXEMPTIONS only.)
Immunized
*
Yes
No
Siblings (names & ages)
Name (age)
PARENT/GUARDIAN INFORMATION
Parent/Guardian-1 Full Name
*
Please include First and Last name
Email-1
*
example@example.com
Cell Phone-1
*
Parent/Guardian-2 Full Name
Please include First and Last name
Email 2
example@example.com
Cell Phone-2
Comment
Please include mailing address here.
Church Affiliation (if any)
Check box if you plan to apply for tuition assistance.
(Applications will be sent at a later date.)
Tuition Assistance
Yes
CLASS REGISTRATION
Check the OR box if you do not have a preference on days.
Check the AND box if you want both options.
Wee Waddlers
Wee Waddlers (Friday, 9:30-11AM - $60)
Young Twos
Young Twos M/W (9:30-11:30AM - $200)
OR
AND
Young Twos T/Th (9:30-11:30AM - $200)
Older Twos
Older Twos M/W (9:30-11:30AM - $200)
OR
AND
Older Twos T/Th (9:30-11:30AM - $200)
Threes
Threes (2-day) T/Th (9:15-11:45AM - $230)
OR
AND
Threes (3-day) M/W/F (9:15-11:45AM - $345)
Fours
Fours (4-day Pre-K) M-Th ($385)
Fours (5-day Pre-K) M-F ($480)
Standard Enrichment Registration (Fours only)
Noon-3PM two days/week for $225
St-E Days
M/W
OR
AND
T/Th
Spanish Enrichment Registration (Fours only)
Noon-3PM two days/week for $225
SP-E Days
M/W
OR
AND
T/Th
Class Assignment(s)
Preview PDF
Print Form
Register My Child
Notes
Upon placement, you will be invoiced a non-refundable $100 registration fee due within one week of receiving invoice.
Make checks payable to John Knox Community Preschool (JKCP JKCP reserves the right to place children as appropriate for class needs. Minimum enrollment required for class to take place.
Should be Empty: