2024-2025 Registration Form
A $130.00 registration fee is required to complete your registration. You will find payment options below. Registrations will be reviewed as they are received. You will receive an acceptance letter or a waitlist letter via email with in 7 days. If the class you are interested in is full, you can join the waitlist below. Payment is not needed to join the waitlist for classes, only once we can guarantee your spot. If you have any questions please do not hesitate to email me at madisonsmns@gmail.com.
Currently enrolled
*
Please Select
YES
NO
Child's Name
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First Name
Last Name
Preferred Name
Birth Date
*
Please select a month
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Month
Please select a day
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Day
Please select a year
2024
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Year
Child's age as of August 31, 2024
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Gender
*
Please Select
Female
Male
Preferred Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mother's Name
*
Mother's Phone Number
*
-
Area Code
Phone Number
Father's Name
*
Father's Phone Number
*
-
Area Code
Phone Number
Emergency Contact #1
*
First Name
Last Name
Emergency Contact Relation
*
Emergency Contact #1 Phone Number
*
-
Area Code
Phone Number
Emergency Contact #2
*
First Name
Last Name
Emergency Contact Relation
*
Emergency Contact #2 Phone Number
*
-
Area Code
Phone Number
Doctor's Name
*
Doctor's Office Phone Number
*
-
Area Code
Phone Number
Any speech or hearing difficulties?
Allergies
Children in family and ages
Comments about child's nature, any fears, or other pertinent information:
Please select the program you would like your child to attend (3 and 4 year old classes, students must be potty trained):
*
18 month olds - 2 days (Tuesday & Thursdays) $130 per month
2 year olds - CLASS IS FULL. SELECT TO JOIN WAITLIST. 3 days (Mon, Wed, Fri) $150 per month
2 year olds - CLASS IS FULL. SELECT TO JOIN WAITLIST. 5 days (Mon-Fri) $170 per month
3 year olds - 3 days (Mon, Wed, Fri) $150 per month
3 year olds - 5 days (Mon-Fri) $170 per month
4 year olds - 3 days (Mon, Wed, Fri) $150 per month
4 year olds - CLASS IS FULL. SELECT TO JOIN WAITLIST. 5 days (Mon-Fri) $170 per month
4 Plus STEAM - CLASS IS FULL. SELECT TO JOIN WAITLIST.5 days (Mon-Fri, extended day Tues/Thurs 9-1) $220 per month ***must turn 4 by August 31, 2024 and plan to enter Kindergarten for the 2025-2026 school year.
Parent/Guardian Signature
*
Registration Fee $130.00
*
Please Select
CASH
CHECK(make payable to St. Mary's Nursery School)
VENMO (see below, please put childs first and last name in comments)
Submit
Should be Empty: