FEL Weekday Preschool Registration

Foundations Early Learning Preschool

First Baptist Church Lake Wales
Student Information
Full Name
Name to be called/written at school
Date of Birth
Gender

MaleFemale
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number
Please enter a valid phone number.
Previous Preschool/Childcare
Church Affiliation
I would like information and/or a visit from First Baptist Church of Lake Wales
Consistent with Christian principles, Foundations Early Learning does not discriminate with regard to race, sex or national origin in the administration of its educational policies or other school-administered programs. Foundations Early Learning is accredited by the Florida Coalition of Christian Private Schools and is a Ministry of
First Baptist Church Lake Wales.
1-Year-Old Class Morning Program:

Monday-Friday 8:30am-12pm - $320/month

Morning Program & Extended Care

Monday-Friday

8:30am-2:00pm - $520/month

8:30am-4:00pm - $680/month

2's, 3's and 4's Morning Program:

Monday-Friday 8:30am-12pm - $300/month

Morning Program & Extended Care

Monday-Friday

8:30am-2:00pm - $500/month

8:30am-4:00pm - $660/month
I am interested in FEL Extended Care:

YesNoUntil 2:00pmUntil 4:00pm
Child lives with

Both ParentsDadMomOther
If Other, please list name and relationship.
Name(s) & Age(s) of siblings (write N/A if none)
Medical or Developmental Issues (allergies, hearing, eyesight, behavior, attention deficit, etc.) (write N/A if none)
Please provide your child's t-shirt size.
What are some of your child's favorite activities? Favorite toys?
Parent's goal for your child this year:
Is your child potty trained?

YesNo
Wears Pull Ups?

YesNo
Do you give your child permission to participate in food-related activities? These activities inldude things such as classroom cooking projects, gardening, school-wide celebrations, birthdays, and activities that include food prepared and/or purchased by families.

YesNo
Mother's Information
Name
Address (if different)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employer & Occupation
Work Phone
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Email
example@example.com
Father's Information
Name
Address (if different)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Employer & Occupation
Work Phone
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Email
example@example.com
Authorizations & Releases
Emergency Contact Information: * In the absence of parents, child can be released to:
List up to 2 contacts other than parents (Name, Relationship to Child and Phone Number)
Child Pick up Authorization: * other than Parents & Emergency Contacts
List up to 3 contacts other than parents (Name, Relationship to Child and Phone Number)
Child's Physician
Name and Phone Number
Should be Empty:

Foundations Early Learning Preschool

Student Information

Mother's Information

Father's Information

Authorizations & Releases