Little Shepherds Learning Center - Registration for School Year 2023-2024

Child's Name

Child's Date of Birth

Child's Gender

What name should we use for your child, for name recognition?

Tell us about your child's medical conditions or food allergies.

Does your child’s allergy/allergies require child care staff to monitor your child for symptoms to take action if a reaction occurs or give emergency medication to your child?

Yes No

What language do you speak at home?

Parents' Names

Address

Parent Cell Phone

Parent Email for class info and alerts

This address will receive a confirmation email

Do we have your permission to share your contact information on class rosters?

Yes No

Do we have your permission to release your child's photo for church or LSLC publications? (Names will never be used.)

Yes No

Is your child a current student at Little Shepherds?

Yes No

What is your home church?

Does your child have (a) sibling(s) currently attending Little Shepherds?

Yes No

If a sibling is currently attending, please indicate class:

Please select your FIRST class choice:

Age 2.5 years; Little Lambs Toddlers M W 9:20 - 11:55 am Age 2.5 years; Little Lambs Toddlers T Th 9:20 - 11:55 am Age 3; Lambs Preschool T Th 9:20 - 11:55 am Age 3-4 years; Rainbows Preschool M T W 9:20 - 11:55 am PreK age 4; Shepherds PreK M T W Th 9:15 - noon PreK age 4-5; Disciples PreK M T W Th 9:15 - noon Kindergarten Enrichment M T W am 9:15 - 11:45 am Kindergarten Enrichment M T W pm 1:00 - 3:15 pm

Please select your SECOND class choice:

Please read the 2023- 2024 Tuition Agreement.

Please check to acknowledge that you have read and agree with the details on the Tuition Agreement.

Yes No

Please read the Covid-19 Mitigation & Guidelines.

Please check to acknowledge that you agree to follow all COVID-19 requirements.

Yes No

A non-refundable fee of $225 is due today with your registration. $225

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Little Shepherds Learning Center - Registration for School Year 2023-2024

Description

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