Little Shepherds Learning Center - Registration for School Year 2024-2025

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 3; Lambs Preschool M W 9:20 - 11:55 am

Or, please enter your FIRST class choice.

Please select your SECOND class choice:

Age 3; Lambs Preschool M W 9:20 - 11:55 am

Or, please enter your SECOND class choice.

Please read the 2024-2025 Tuition Agreement.

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

Yes No

Please read the Parent Handbook.

Please check to acknowledge that you have read the Parent Handbook.

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

Description

Please fill out this form and click submit when complete. If you have any questions, please contact Sue Miller, Sunday School Director, at 614.766.6377 or smiller@princeofpeacedublin.org.

We are so glad to have you join us!

Little Shepherds Learning Center - Registration for School Year 2024-2025

Description

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