Little Panthers Learning Den

Little Panthers Learning Den

Registration Form
Dear Parents,

Thank you for considering Little Panthers Learning Den preschool for your child's early education journey. To enroll your child, please complete the attached form in full and submit it along with the non-refundable registration fee of $85 to secure your child's spot. Our tuition pricing is structured by age group and is charged weekly as follows:

Full Time Rates:

- 1-11 months: $205
- 12-17 months: $195
- 18-23 months: $185
- Two years: $185
- Three years: $180
- Four/Five years: $175

Part Time Rates:

- 3 Days 18-23 months: $135 2 Days 18-23 months: $120

- 3 Days Two years: $135 2 Days Two years: $120

- 3 Days Three years: $130 2 Days Three years: $115

- 3 Days Four/Five years: $125 2 Days Four/Five years: $110

Our hours of operation are from 6:30 AM to 6:00 PM, Monday through Friday.
Full name of child*

First NameMiddle NameLast Name
BoyGirl
Date of birth*

MonthDayYear
Date
Expected Start Date:

MonthDayYear
Date
Mother's Name*

First NameMiddle NameLast Name
Email
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Father's Name*

First NameLast Name
Email
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
MotherFatherBothOther
Please specify
Person authorized to pick up child

First NameMiddle NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Person to call in case of emergency

First NameLast Name
Name

First NameMiddle NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Signature of parent*

Powered by Jotform SignClear
Registration Fee*
prevnext( X )
Registration Fee
Per Child

$85.00 Number of Children enrolling
Item subtotal:$0.00

Total

$0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Should be Empty: