New Registration Form
2026-2027
Name of Person Completing this Form
First Name
Last Name
Your child will be enrolled in: (Check the program)
Toddler (Turns 2 by August 1)
Toddler (Turns 2 after August 1 may enroll up to November 1st with the understanding of completing another year in the Toddler Program.)
Pre-K 3 (Turns 3 by August 1)
Pre-K 4 (Turns 4 by August 1)
Child's Name
First Name Middle Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Gender
Male or Female
Date of Birth
-
Month
-
Day
Year
A copy of the child's birth certificate must be submitted to the school office.
CIty of Birth
Mother's Name
First Name Maiden Name
Last Name
Mother's Cell Phone Number
Please enter a valid phone number.
Mother's Email
example@example.com
Mother's Address -- (If not same as child, indicate your address)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Father's Name
First Name
Last Name
Father's Cell Phone Number
Please enter a valid phone number.
Father's Email
example@example.com
Father's Address -- (If not same as child, indicate your address.)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent Signature
*
Submit
Submit
Should be Empty: