Registration Form 2026-2027

2026-2027 Registration Form

A $140.00 registration fee is required to complete your registration. You will find payment options below. Registrations are not complete until payment is received. Registrations will be reviewed as they are received. Registration fees are non-refundable upon receipt of payment.You will receive an acceptance letter or a waitlist letter via email within 7 days of submission. If the class you are interested in is full, you can join the waitlist below. Payment is not needed to join the waitlist for classes, only once we can guarantee your spot. If you have any questions please do not hesitate to email me at madisonsmns@gmail.com.
Currently enrolled
Child's Name

First NameLast Name
Preferred Name
Birth Date

MonthDayYear
Child's age as of August 31, 2026
Gender
Preferred Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mother's Name
Mother's Phone Number

Area CodePhone Number
Father's Name
Father's Phone Number

Area CodePhone Number
Emergency Contact #1

First NameLast Name
Emergency Contact Relation
Emergency Contact #1 Phone Number

Area CodePhone Number
Emergency Contact #2

First NameLast Name
Emergency Contact Relation
Emergency Contact #2 Phone Number

Area CodePhone Number
Doctor's Name
Doctor's Office Phone Number

Area CodePhone Number
Does your child have any speech or hearing difficulties?
Does your child have any known allergies? If so, how are they treated?
Does your child have asthma? If so, how is it treated?
Does your child take any medication? If so, what is the medication and its purpose?
Children in family and ages
Comments about child's nature, any fears, or other pertinent information:
Please select the program you would like your child to attend (3 and 4 year old classes, students must be potty trained to attend):
I hereby agree to follow St. Mary's Nursery School polices and procedures for the 2026-2027 academic year. I understand that registration is not complete with out the registration fee. I also understand that the registration fee is non-refundable upon receipt of payment.
Parent/Guardian Signature
Registration Fee $140.00
Should be Empty:

2026-2027 Registration Form