Epworth's Preschool & Kindergarten Registration 2025-2026

Epworth's Preschool & Kindergarten Registration 2025-2026
We are so glad that you’re here to register your little one for a year full of laughter, learning, and new adventures! We believe every child is a shining star, and we can’t wait to nurture their curiosity, creativity, and love for learning.

If you have any questions—big or small—we’re here to help! Feel free to reach out to us anytime. We can’t wait to welcome your family into ours! 💛

📞 (301) 977-3421
📧 preschool.director@eumc-md.org
🌐 https://www.epkgaithersburg.org/
Child's Enrollment Information
Child's First Name*
Child's Last Name*
Preferred First Name:
Child's Date of Birth*

MonthDayYear
NOTE: CHILDREN MUST 2 YEARS OLD BY SEPTEMBER 1ST TO BE REGISTERED FOR OUR 2's PROGRAM.
Gender Assigned at Birth:*

FemaleMale

Family Information
Parent/Guardian Name 1: *

First NameLast Name
Relationship to Child: *
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary / Home or Cell Phone:*
Please enter a valid phone number.
Secondary / Work Phone:
Please enter a valid phone number.
Email*
example@example.com
Employed By: *
Parent/Guardian Name 2:

First NameLast Name
Relationship to Child:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Primary / Home or Cell Phone
Please enter a valid phone number.
Secondary / Work Phone
Please enter a valid phone number.
Employed By:
Does the child live with both parents:*

YesNo

Please list any other members of the household below and indicate each individual's age and relationship to the child you are enrolling:

	Name	Age	Relationship to Child
1
2
3
4

Would you like to be considered for financial assistance for the upcoming school year's tuition?*

YesNo
Please enter the combined total household income for all parents/guardians (even if the parents/guardians live separately). You may round to the nearest dollar:*
How did you learn about our school?

Agreements
Thank you for the information you have provided. Please review the following information:

Based on your selections, your estimated first payment for {childsFirst}'s tuition (due by no later than May 1, 2025) is: ${selectThe}.

This includes the registration fee and any discounts that were applied when you completed the program selection portion of the form. Please note that your child's placement is not complete until you have submitted payment.

IMPORTANT: Please be sure that you have made a selection from the dropdown menu within the program you checked. Our prices vary depending on the number of days per week your child will be attending. If you did not select the correct schedule, your estimate could be inaccurate.

By signing below, I confirm that, to the best of my knowledge, the information provided in this form is true and accurate. I also give permission for my child to fully participate in all activities and programs offered by Epworth Preschool & Kindergarten.

Financial Agreement
- The $95.00 registration fee is non-refundable.
- May 2026 tuition, paid at the time your registration is approved, is non-refundable and will not be applied to any other month.
- September tuition and the annual activity fee are due August 1st.
- Tuition is due on the 1st of each month. A $10.00 late fee will be assessed if the tuition is not paid by the 5th of the month.
- Parents who arrive late for pickup after their child’s registered program has ended will be charged a late fee of $1.00 per minute.
After you have submitted this form, our Preschool Director will review your registration information. Once your spot has been confirmed by the Director, you will be provided a link at {email} to pay the registration fee + May 2026 tuition. Payment is required to permanently secure your spot.

By signing below, I confirm that I have read and understand the above. I agree to all terms of the Financial Agreement.
Parent/Guardian Signature

Clear
Date*

MonthDayYear
Date
Should be Empty:

Epworth's Preschool & Kindergarten Registration 2025-2026

Child's Enrollment Information

Program Selection

Please select only ONE 9:00 AM - 1:00 PM Program for this registration. If you have other children you would like to register, please submit a separate form for each.

Based on the birthdate you entered for your child, our Preschool Director will be contacting you regarding a waiver and early entrance assessment.

Please check your selection. Your child may not qualify for the program you have selected based on the birthdate you have entered.

You cannot select the TK After Care option unless your child is enrolled in the TK program (5's - Transitional Kindergarten). Please select the 1:00 - 4:00 PM After Care option to continue.

You have selected the Transitional Kindergarten program. If you would like to enroll in After Care as well, please select the TK After Care 2:00 PM - 4:00 PM option to continue.

Based on the birthdate you entered for your child, your child will not yet be 2-years-old by September 1st. Unfortunately, our licensure does not allow us to serve children who are not at least 2 years of age by September 1. We hope you'll consider us in the future.

Child's Medical and Developmental Questionnaire

Family Information

Agreements

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