2026 registration SUMMER

Community Preschool Registration Form

SUMMER 2026
Session 1: June 22 - July 17

Session 2: July 20 - August 14

Please complete ALL QUESTIONS.
Child's Name
Date of Birth

MonthDayYear
Date
Boy? Girl?

BoyGirl
Address
Town
Zip Code
Parent Name

First NameLast Name
Phone: (C)
Address (write same if doesn't differ from child's address)
Occupation
Work Phone:
Parent's Email Address
example@example.com
2 Parent's Name
Phone (C)
Address: (If different than parent 1)
Work Phone
Occupation
Parent's Email Address
example@example.com
Language(s) spoken at home
Your child's siblings name(s) and ages
Your child's group experiences
Your child's ALLERGIES
Any food restrictions? (vegan, vegetarian, etc)
Receiving services from a therapist? (speech, physical, behavioral therapy)
Anything we should know to better serve your child? (speech delay, born prematurely, any concerns you may have)
How did you hear about us?
AUTHORIZED EMERGENCY CONTACTS: (other than parents)

Please list persons who are authorized to pick-up your child in case of emergency if neither parent is available.
Person #1
Cell Phone
Relationship to Child
Person #2
Cell Phone
Relationship to Child
Program options: Half Day: 8:45-11:45 OR FULL DAY: 8:45-3:45
ENTIRE SESSION 1 June 22- July 17

2 Half days/week3 Half days/week5 Half days/wee2 FULL days/week3 FULL days/week5 FULL days/weekBefore CareAfter Care
ENTIRE SESSION 2 July 20- August 14

2 Half days/week3 Half days/week5 Half days/week2 FULL days/week3 FULL days/week5 FULL days/weekBefore CareAfter Care
If our 4-week block sessions don't fit your needs, you may pick your weeks. NOTE that only 5 days/week, either half or full, are available for the "pick your week(s)". We do not offer the "pick your week(s)" option for 3 or 2 days/week. However you may choose to pay for a full week and only send your child for the days that work with your schedule.

Please choose from the options below and check all that applies.
WEEK 1: June 22 to June 26

5 Half days5 FULL DAYSBefore CareAfter Care
WEEK 2: June 29 to July 3

Half Days5 FULL DAYSBefore careAfter Care
WEEK 3: July 6 to July 10

5 Half days5 FULL DAYSBefore CareAfter Care
WEEK 4: July 13 to July 17

5 Half days5 FULL DAYSBefore CareAfter Care
WEEK 5: July 20 to July 24

5 Half days5 FULL DAYSBefore CareAfter Care
WEEK 6: July 27 to July 31

5 Half days5 FULL DAYSBefore careAfter Care
WEEK 7: August 3 to August 7

5 Half days5 FULL DAYSBefore CareAfter Care
WEEK 8: August 10 to August 14

5 Half days5 FULL DAYSBefore CareAfter Care
I need before care 7:45 am - 8:45 am

5 days per week for my PK43 days per week for my PK45 days per week for my PK3 or 23 days per week for my PK3 or 2I do not need before care
I need after care 3:45 pm - 5:00 pm

5 days per week for my PK43 days per week for my PK45 days per week for my PK3 &or 23 days per week for my PK3 or 2I do not need after care 5
My child's spot may be given away as needed, if tuition for one 4-week session or 2 weeks, (if registered in the per week option) isn't paid by June 1 for Session 1: June 22 to July 17, and July 1 for Session 2: July 20 to August 14, and a $50 late fee will also be added to the tuition amount due. By signing this financial agreement, I am the person responsible for tuition payments and all discussions about this agreement will also be my responsibility.

The school reserves the right to combine age groups.
Your child's name

First NameLast Name
Financial Agreement:

It is my desire to enroll ______________________________in Community Preschool for the 2026 Summer Fun Program. I agree with the policies and financial terms of the school as stated in the pamphlet and handbook. At the time of registration, a $100 non refundable deposit is due to reserve your child’s space. Tuition for one 4-week session (or 2 weeks if registered in the “per week” option) is due by June 1st, 2026. I understand that all fees are non-refundable and that the session/week(s) must be paid in full before my child(ren) may attend. Days missed for ANY reason including covid are not refundable, not transferable to another child and may not be swapped, credited or added to a different week.My child’s spot may be given away if tuition for one 4-week session (or 2 weeks if registered in the “per week” option) isn’t paid by June 1 for June 22 to July 17, and July 1 for July 20 to August 14, and a $50 late fee will be added to the tuition amount due. By signing this financial agreement, I am the person responsible for tuition payments and all discussions about this agreement will also be my responsibility.
Signature

Clear
Date

MonthDayYear
Date
Should be Empty: