2026-2027 Registration
Child's Name
*
First Name
Last Name
Child's Date of Birth
*
-
Month
-
Day
Year
Date
Parent/ Guardian 1 Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian 2 Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Allergies and Special Needs (click all that apply)
*
Food Allergy
Food Intolerance
Other allergy
Existing Illness
Previous serious illnesses
Activity restrictions, limitations, or modifications
Speech
Developmental concerns
Other special need
None
If yes above please provide additional information on special needs or concerns.
I grant permission for my child to use all of the play equipment and participate in all the activities of the school.
*
Yes
No
St. Luke's Operational Policies.
I acknowledge receipt of "St. Luke's Operational Policies".
*
Yes
No
Financial Policies
I understand and will comply with the financial policies of St. Luke's Preschool & Kindergarten.
*
Yes
No
I give consent for the facility to secure any and all necessary emergency medical care for my child.
*
Yes
No
Signature of parent or guardian
*
My child is enrolling for: (All children must be toilet trained by the first day of school)
*
Pre-K 3 Monday-Friday
Pre-K 3 Monday/Wednesday/Friday
Pre-K 3Tuesday/Thursday
Pre-K 4 Monday-Friday (Full Join Wait List)
Pre-K 4 Monday/Wednesday/Friday
Pre-K 4 Tuesday/Thursday
Kindergarten Monday-Friday (Full-Join Wait List)
Extended Day Tuesday/Thursday
Submit
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