OSLP Enrollment Information 2024-2025

Preschool Student Enrollment Form

Please fill out all of the form below to the best of your knowledge.
Child's Full Name*

First NameLast Name
Child's Age*
Please select your child's age
Child's Date of Birth*

MonthDayYear
Please select your child's date of birth
Child's Sex*

MaleFemale
How would you describe your child?*

Native American/Alaskan NativeAfro-AmericanHispanicAsianCaucasianOther
What class are you enrolling for?
What is your church affiliation, if any?
Notice of Non-Discrimination: Our Savior's Preschool prohibits discrimination on the basis of race, sex, religion, color, creed nation or ethnic origin. This preschool is required to report on the racial composition of it's students to the government. Self-identification is voluntary.

Primary Parent/Guardian Information
Primary Parent/Guardian Name*

First NameLast Name
Marital Status*

SingleMarriedDivorcedWidowerOther
Primary Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Please enter a valid phone number.
Primary Email*
example@example.com
Job & Company/Employer*
Company/Employer Address*

Street Address

Street Address Line 2

CityState

Zip Code
Work Phone Number*
Please enter a valid phone number.
Instructions on how to find parent/guardian during preschool hours.*
How did you hear about OSLP?*

Emergency Contacts

Please provide 3 adult contacts OTHER THAN THE PRIMARY PARENT/GUARDIAN who are able to help in the event of an emergency.
Emergency Contact 1*

First NameLast Name
Emergency Contact 1 Address*

Street Address

Street Address Line 2

CityState

Zip Code
Emergency Contact 1 Phone*
Please enter a valid phone number.
Emergency Contact 2*

First NameLast Name
Emergency Contact 2 Address*

Street Address

Street Address Line 2

CityState

Zip Code
Emergency Contact 2 Phone*
Please enter a valid phone number.
Emergency Contact 3*

First NameLast Name
Emergency Contact 3 Address*

Street Address

Street Address Line 2

CityState

Zip Code
Emergency Contact 3 Phone*
Please enter a valid phone number.

NONE Parent/Guardian Authorized Pick Up

Please List up to 4 additional people who you give permission to pick- up your student.
Authorized Person #1
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Name

First NameLast Name
Authorized Person #2
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Authorized Person #3
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Authorized Person #4
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.

Medical Information
Medical Insurance*
Medical Insurance Policy Number*
Copy of your Medical Insurance*

If you are able, please upload a copy of your insurance card
Cancelof
Child's Medical Provider

First NameLast Name
Medical Provider address*

Street Address

Street Address Line 2

CityState

Zip Code
Medical Provider Phone*
Please enter a valid phone number.
Child's Dentist*

First NameLast Name
Dentist Address*

Street Address

Street Address Line 2

CityState

Zip Code
Dentist Phone *
Please enter a valid phone number.
Hospital of Choice*
In the event of an emergency which hospital would you like us to try and go to?
Does your child have any allergies, dietary needs or physical/learning limitations?

Medical Statement of Health

Please download this form and have your Healthcare Provider fill it out and submit it here or email it to the preschool at preschooloursaviors@gmail.com
Statement of Health
Upload Medical Forms (Statement of Health & Immunization Record or Completed Exemption form

Cancelof
We are required to have a health form signed and dated by a health care provider as well as an up to date immunization record or completed exemption form every year. do you agree to having both returned to Our Savior's Lutheran Preschool before the child can start school.*

I understand and agree to the above.

Emergency Authorization
I give my permission to Our Savior's Preschool and Our Savior's Lutheran Church to call a doctor for medical care for my child should an emergency arise. It is understood that the school will call 911 and would make a reasonable effort to locate me. I have listed three(3) emergency references, our physician and our dentist in my child's file. I will accept any expenses regarding my child's medical emergency and care.*

Powered by Jotform SignClear
Field Trip Authorization
I give my permission and consent for my child to take part in field trips or excursions away from the preschool premises weather on foot or by vehicle. I understand that my child will be under the supervision of the preschool staff and other adults that are assisting. I also understand that the preschool will notify me of any planned excursions or field trips. It is my responsibility to read the newsletters/remind notifications regarding this, and contact the school if I do not wish for my child to participate.*

Powered by Jotform SignClear
Media Release
I give consent for my child to view a video under staff supervision. I will contact my child's teacher if I do not wish for my child to participate.*

Powered by Jotform SignClear
General Release Statement
I, as a parent or legal guardian of the child listed above, in consideration for the use of preschool facilities and playground or Our Savior's Preschool and Our Savior's Church, do hereby release and forever discharge Our Savior's preschool and Our Savior's Lutheran Church from any and all matters of action, causes of actions, suits, proceedings, damages, claims and demands whatsoever in law and equity, which I had, now have, or may have in the future as a result of the use of the facilities and grounds. This release is binding on the heirs, executors, administrators, personal representatives, and assigns of the parties hereto.*

Powered by Jotform SignClear
Today's Date*

MonthDayYear
Ple.ase select the date you sign this document
Here you have the option to pay for preschool in full for a discount. This is not a requirement just an option we offer at a 10% Discount.
Tuition Pay-in-full Options (Pay for the whole year and get 10% Off)
prevnext( X )
TU/TH Class- Year In-Full(9 payments $135) Beginner classes (3 yrs old) + $40 in supply fees for the year
$1,130.00

M/W/F AM or M/Tu/W/Th PM Class- Year in Full$1950.00/year (9 payments $190) Pre-K + $50 in supply fees for the year
$1,755.00

Total

$0.00

Payment Methods

Please click one of the PayPal options to complete payment and submit the form.
Should be Empty:

Preschool Student Enrollment Form

Notice of Non-Discrimination: Our Savior's Preschool prohibits discrimination on the basis of race, sex, religion, color, creed nation or ethnic origin. This preschool is required to report on the racial composition of it's students to the government. Self-identification is voluntary.

Primary Parent/Guardian Information

Emergency Contacts

NONE Parent/Guardian Authorized Pick Up

Authorized Person #1

Authorized Person #2

Authorized Person #3

Authorized Person #4

Medical Information

Medical Statement of Health

School Experience

Social & Emotional Experience

Toilet Habits

Emergency Authorization

Field Trip Authorization

Media Release

General Release Statement

Here you have the option to pay for preschool in full for a discount. This is not a requirement just an option we offer at a 10% Discount.