2023-24 PRESCHOOL REGISTRATION FORM

2023-24 Enrollment Application

(a separate form must be submitted for each child)
Registration information

Once this application is received and processed, you will be notified via email of potential placement and receive a PayPal invoice for the *nonrefundable* registration fee of $150, which is required to hold your child's spot. If a spot is not available for your child at the time of application, you will receive an email notification of your placement on our waitlist. You will not be invoiced for the registration fee unless/until a spot opens up for your child.
Class times and tuition

Our classes meet on MONDAYS and WEDNESDAYS from 9AM-2:30PM The tuition breakdown is as follows (based on age/development as of September 1): Caterpillars (12m-17m): $220/mo Butterflies (18m-23m): $220/mo Sprouts (24m-2.5y): $200/mo All other classes: $190/mo There is a 10% sibling discount for each additional child. For example, if you are enrolling a one year old, a three year old, and a four year old, you would be invoiced monthly at $220 for the first child, with a discounted rate of $171 for the two others, for a monthly total of $562. Tuition is invoiced via PayPal on the 1st of each month, with payment considered late after the 5th. Tuition has been averaged out over the year and is therefore collected regardless of the number of educational days per month (Christmas break, spring break, etc.). We cannot offer discounts or refunds for days missed due to family illness or bad weather closures. We can only accept paper checks if paying upfront for the semester. Late fees will be assessed for tuition payments received after the 5th unless prior arrangements have been made with the Preschool Director.
Early Bird and Late Day

You may sign up for our optional Early Bird (7:30-8:45am) and/or Late Day (2:30-3:45pm) sessions for an additional fee (sibling discount does not apply). Please see below.
Indicate below if you would like to utilize one or both of these optional services. This may be changed on a month-to-month basis.

Early Bird, $40/monthLate Day, $40/monthBOTH Early Bird AND Late Day, $60/month
CHILD’S BASIC INFORMATION
Child's Full Name:*
Date of Birth:*

MonthDayYear
This is used for classroom placement. Please DOUBLE CHECK birth year accuracy.
Preferred Name/Nickname:
Gender:*

FemaleMale
Please upload a recent photo of your child for classroom use. File must be in jpeg or png format.*
Audio/Visual Information:*

I understand that my child may be photographed or recorded at Foundation Kids Preschool during normal school hours or special activities.I understand that these photographs or videos may be posted (without your child's name) in school newsletters/bulletin boards, or posted on our website, social media, or other publication for publicity or information purposes.I understand that, if consent is now given below, I have the right to rescind that consent in writing at any time.
Audio/Visual Consent*

Yes, I confirm that I have read and understand the above and give permission for my child’s image to be used in the manner described.No, I do not wish to have my child’s likeness used in the manner described.
Child lives with:*
Parents' Marital Status:
If separated, who has primary legal custody?
May the non-custodial parent pick up the child?

YesNo (court documentation is required)
CHILD’S HEALTH INFORMATION
Does your child have any known allergies?*

YesNo
If yes, please list the allergen(s) and describe how your child reacts to exposure.
How are these allergies typically treated?
Is your child potty-trained?*

YesNoIn progress
Does your child take daily medication that needs to be administered during the school day?*

YesNo
If yes, please list them below.
Please indicate below which general use medication we may use as necessary.

Diaper creamInsect repellantCortisone/anti-itch creamAntibiotic ointmentSunscreen
Are there any other medical issues or special needs (emotional/sensory/physical) we should know about? This includes acute separation anxiety, problems with loud noises, etc.*
We will make every effort to accommodate your child but some needs may be beyond our current capabilities. We highly recommend you discuss potential needs with our Director before registering.
Emergency Medical Care: In the event I cannot be reached to make arrangements for emergency medical attention, I authorize the staff of Foundation Church and Foundation Kids Preschool to seek assistance from the following physician and/or have my child transported for emergency care to the following emergency medical care facility:
Physician's Name:
Clinic:
Phone #:
Address:
Emergency Care Facility Name:
Immunization Record*

I am attaching a copy of my child’s current immunization record.I am excluding my child from immunization requirements for reasons of conscience. I have attached an official notarized affidavit issued by the Department of State Health Services. I understand this affidavit is only valid for two years.My child cannot receive immunizations for medical reasons. I have attached a statement of exclusion from my child’s physician.My child is a returning student and you have his/her current immunization documentation on file. If I previously submitted a notarized affidavit of exclusion, I understand a new one must be submitted every two years.
Please upload your child's immunization documentation as indicated above.
Your child's enrollment is not considered complete until the required form is submitted.
GUARDIAN #1 INFORMATION

This is the person we will contact first if the need arises.
Guardian's Name:*
Relationship to Child:*
Address:*
Cell Phone #:*
Email Address:*
Driver's License #:
GUARDIAN #2 INFORMATION

This is the person we will contact second if the primary guardian is unavailable.
Guardian's Name:
Relationship to Child:
Address:
Cell Phone #:
Email Address:
Driver's License #:
EMERGENCY CONTACT #1

List a person who will assume responsibility if guardian(s) cannot be reached.
Emergency Contact Name:*
Relationship to Child:*
Cell Phone #:*
Driver's License #:
EMERGENCY CONTACT #2

List a person who will assume responsibility if guardian(s) cannot be reached.
Emergency Contact Name:
Relationship to Child:
Cell Phone #:
Driver's License #:
Phone #:
Address:
PayPal Invoicing

We use PayPal invoicing to collect registration fees and monthly tuition. To whom should we send the invoices?
PayPal Invoice Recipient*

First NameLast Name
Email*
example@example.com
Confirmation of Intended Enrollment

I have reviewed the above responses for any errors and certify all entries are correct to the best of knowledge. I understand that incorrect/incomplete information may delay the processing of my enrollment.
By completing this registration form:*

I confirm that I have read and will abide by all the policies and procedures as outlined in the Parent Handbook, which is available for download at foundationgmc.org/preschool. I understand that I will receive a hard copy at Meet the Teacher Night in the fall.I give consent for the staff of Foundation Church/Foundation Kids to secure any and all necessary emergency medical care for my child at my own expense.I understand that classes may be divided or combined based on enrollment and that my child's birthdate is only one factor of appropriate class placement.I have double-checked that my phone number, my email address, and my child's birthday are entered correctly.I understand that, if offered placement, my registration fee is *non-refundable* and I will notify the preschool office as soon as possible if my status changes so my child's spot can be released to those on the waiting list.
Parent/Guardian Electronic Signature*

Clear
Today's Date*

MonthDayYear
Should be Empty:

Registration information

Class times and tuition

Early Bird and Late Day

CHILD’S BASIC INFORMATION

CHILD’S HEALTH INFORMATION

GUARDIAN #1 INFORMATION

GUARDIAN #2 INFORMATION

EMERGENCY CONTACT #1

EMERGENCY CONTACT #2

PayPal Invoicing

Confirmation of Intended Enrollment