Clover Presbyterian Preschool 2025-2026 Registration Form

Clover Presbyterian Preschool Registration Form 2025-2026
- January 27, 2025 - January 31, 2025 - Registration for Current Students and Church Members
- February 3, 2025 - Registration Opens to the community at 8am
- $150 Registration Fee for First Child
- $110 Registration Fee for Each Additional Child
Email for Important Registration Information *
example@example.com
Please select the option that best describes your child.*

My child is a current studentMy child is a current member of Clover Presbyterian Church.My child's sibling is a current student.My child is new to Clover Presbyterian Preschool.

	First Choice
Two Day - Tuesday/Thursday - $300/Month

Authorization for Medical Information
I hereby grant permission for any staff person from Clover Presbyterian Preschool to take whatever steps may be necessary to obtain emergency medical treatment for my child. These steps include, but are not limited to the following:
1. Attempt to contact parent or guardian.
2. Attempt to contact the child's physician.
3. Attempt to contact the parent through any of the emergency contacts listed below.
4. If we cannot contact you, we will call an ambulance and have your child taken to the emergency room.
I agree and understand the above statement.
I understand that I am responsible for any resultant medical treatment expenses.
Emergency Contact 1*

First NameLast Name
Emergency Contact 1 Phone *
Emergency Contact 2*

First NameLast Name
Emergency Contact 2 Phone *
Emergency Contact 3*

First NameLast Name
Emergency Contact 3 Phone *
Is your child covered by personal/family medical insurance?*

YesNo
Insurance Company and Policy Number*

Authorized Pick Up
If my child is to be picked up by anyone other than myself or spouse, I will notify the teacher in writing or in the case of emergency will call the preschool.

I understand that anyone listed below may pick up my child. These individuals must provide a picture ID.
If my child is to be picked up by anyone other than myself or spouse, I will notify the teacher in writing or in the case of emergency will call the preschool.
I understand that anyone listed below may pick up my child. These individuals must provide a picture ID.
Authorized Pick Up 1*

First NameLast Name
Authorized Pick Up 1 Phone *
Authorized Pick Up 2*

First NameLast Name
Authorized Pick Up 2 Phone *

Security Video Release and Acknowledgement

In order to promote the safety of children, staff and visitors, Clover Presbyterian Preschool has video surveillance cameras throughout the facility, excluding restrooms.
I acknowledge and have been notified of the video surveillance cameras

Photo Release

We love to take pictures at Clover Presbyterian Preschool. We use them to create bulletin boards, individual end of the year memory books, class projects, CPC website, and to show the kids having fun, playing, and learning. We would like your permission to photograph/videotape your child for use in these projects. Photos will remain the property of CPP unless otherwise noted.
Please check all that apply:*

I give my permission for photos to be taken for use in my child’s memory book, class or individual projects, and preschool displays within the church.I give my permission for photos to be added to the private CPP FB Group. (Pictures of children’s faces are never added to our public FB page.)I give my permission for photos to be added to the preschool website.I give my permission for any photo/video to be taken by preschool staff and included in marketing materials such as website, advertisements, etc. for the discretional use for Clover Presbyterian Preschool.DO NOT USE MY CHILD'S PHOTO

Email Address and Phone Release
If another parent in the Clover Presbyterian Preschool program asks:*

My email address may be shared.My phone number may be shared.DO NOT SHARE MY INFORMATION

Monthly Tuition

Tuition is due the 15th of each month. First month's tuition is due June 15, 2025 and once paid, is non-refundable. Payments received after the 25th of each month will be subject to a $25 late fee. If tuition is not received by the last day of the month, your child will not be allowed to attend until tuition is paid.
I understand tuition is due the 15th of each month. First month's tuition is due June 15, 2025 and once paid, is non-refundable.
Payments received after the 25th of each month will be subject to a $25 late fee. If tuition is not received by the last day of the month, your child will not be allowed to attend until tuition is paid.

Withdrawal Policy

If you choose to withdraw your child at any time during the school year, you must give a written 30 days notice to the director. There will be no refunded payments for mid-month withdrawals.
I understand that if I choose to withdraw my child at any time during the school year, I must give a written 30 days notice to the director. I understand there will be no refunded payments for mid-month withdrawals.

Payment Methods

Check and ACH withdraws are the preferred methods of payment for Clover Presbyterian Preschool. Electronic payments with debit or credit cards will be charged a $5 convenience fee to cover the processing fees.
I understand that if I opt to use a debit or credit card, I will be charged a $5 convenience fee for each transaction.

Registration Fee:

The Clover Presbyterian Preschool Registration Fee is Non-Refundable. $150 for the first child and $110 for each sibling. Once paid your child has a secure spot for the 2025-2026 school year.
I acknowledge that my child's spot in the 2025-2026 Clover Presbyterian Preschool is not secure until I pay the non refundable registration fee.
Should be Empty:

	First Choice	Second Choice	Third Choice
Three Day - Mon/Wed/Fri - $360/Month
WAIT LIST ONLY - Five Day - Monday- Friday - $430/Month

	First Choice	Second Choice
WAIT LIST ONLY - Four Day - Monday - Thursday - $380/Month
WAIT LIST ONLY - Five Day - Monday - Friday - $425/Month

	First Choice	Second Choice
Four Day - Monday - Thursday - $380/Month
Five Day - Monday - Friday - $425/Month

Child Information