Clone of Early Childhood Registration

Early Childhood Registration Form Summer 2026

Guardian Lutheran School
Welcome to Guardian Lutheran School's Early Childhood Summer Program. This program runs from 6/08-7/31, with 1 week being closed on 7/06-7/10. Current Guardian students can start the week of 6/08. All new students start the week of 6/15. Please fill out all the fields on this form, including selecting your schedule and letting us know which weeks you will not be here. We look forward to having your children with us this summer!

Configurable list*

Parent 1 Name*

First NameLast Name
Relationship to Student*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Cell Phone*
Format: (000) 000-0000.
Employer Name (if does not apply, type NONE)*
Work Phone
Format: (000) 000-0000.
Parent 2 Name

First NameLast Name
Relationship to Student
Address (leave blank if the same)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Cell Phone
Format: (000) 000-0000.
Employer Name (if does not apply, type NONE)
Work Phone
Format: (000) 000-0000.
Additional Parent Name

First NameLast Name
Relationship to Student
Cell Phone
Format: (000) 000-0000.

Emergency Contacts & Release of Child List all individuals, including parents/legal guardians, in order of preference, to be contact in an emergency.*

Rows	Name	Relationship to Student	Phone Number
Contact 1
Contact 2
Contact 3
Contact 4

Name of Child's Physician or Health Clinic*
Physician/s/Health Clinic's Phone No.*
Format: (000) 000-0000.
Allergies, Special Needs and Special Instructions (if does not apply, type NONE)*
FOR NEW FAMILIES - In order to attend Guardian, a copy of your child's immunizations signed by the physician must be given to school office prior to your child attending. We will also need a health appraisal turned in within 30 days of starting the summer program. Health appraisal forms can be picked up in the school office.

My child(ren), continues to be in good general health. He/she/they is able to participate in all activities. There are no physical limitations.
Parent/Guardian Signature:*
Date*

MonthDayYear
Date

- You will be billed weekly, not on a payment plan, and only billed for the days your child is signed up for.
- Payments need to be made the week prior to the week of attendance. If we have not received payment in advance, your child can not attend that following week. For example - payment for the week of 6/15-6/19 will need to be made by the week of 6/08; otherwise, your child can not attend the week of 6/15.
- Changes to your schedule must be requested and approved at least 1 week in advance, otherwise you will be billed according to the previously-submitted schedule. This is necessary to make staffing changes in a timely manner.
- Families are responsible for tuition for the days they sign up for, even if the child does not attend.
- Registration fees are $30/student and are non-refundable. You will be billed an invoice after you register. Additional information regarding how to make payments will be included in the email notification after submission of this form.
PLEASE MAKE YOUR SCHEDULE SELECTION BELOW.

RATES ARE INCLUDED IN EACH DROPDOWN BOX.

Please select schedule below*

Rows	Monday	Tuesday	Wednesday	Thursday	Friday
Choose 1

PLANNED VACATIONS/TIME OFF From your chosen schedule, if you know of any vacation days at this point, please mark them on the below schedule so you do not get billed for those days. If you don't know at this point, please let Mrs. Liggett/Mrs. York know at least 1 week ahead of the time you are requesting off.

Rows	Monday	Tuesday	Wednesday	Thursday	Friday
6/08-6/12 (current students only)
6/15-6/19
6/22-6/26
6/29-7/03
7/13-7/17
7/20-7/24
7/27-7/31

PHOTO PUBLICITY RELEASE

In consideration of the gifts of others, I hereby grant permission for any photographs or publicity involving my child while a student at Guardian Lutheran School to be used in connection with publicity or public relations of Guardian Lutheran School (full names will never be used in conjunction with a picture on social networks or the GLS website).
Parent/Guardian Signature*
Date*

MonthDayYear
Date
** if an exception is needed due to a legal or custody issue, please consult with the principal.
Suggestions / Comments
A positive and constructive working relationship between Guardian Lutheran School and a student’s parents/guardians is essential to the fulfillment of GLS’s educational mission. Thus, Guardian Lutheran School reserves the right not to extend the privilege of enrollment/re-enrollment to a student if Guardian Lutheran School concludes that the actions of the parent(s)/guardian(s) make such a positive and constructive relationship impossible or otherwise seriously interfere with Guardian Lutheran School’s accomplishment of its educational mission. Guardian Lutheran School also reserves the right to not extend the privilege of enrollment/re-enrollment if all information on the application is not truthful. Grade/class placement is determined by Guardian Lutheran School and does not constitute a part of this contract or its subsequent renewals. Such placement is governed by Guardian Lutheran School’s administration and the school handbook. Any conduct by a student which is in violation of the Student Handbook and which Guardian Lutheran School’s administration considers detrimental to the student or to other students of Guardian Lutheran School, may be deemed adequate cause for appropriate disciplinary action, including suspension or dismissal. No transcripts or student files will be released unless all financial obligations are satisfied for this current school year. Guardian Lutheran School admits students of any race, color, nationality, and ethnic origin to all the rights, privileges, programs, and activities accorded or made available to students at the school. It does not discriminate on the basis of race, color, nationality, and ethnic origin in the administration of its educational policies, scholarship programs, and athletic and other school-administered programs.
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Early Childhood Registration Form Summer 2026