Christ UMC Preschool Online Registration

Registration

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Welcome to Christ UMC Preschool! Please complete the following registration form.

* denotes required fields

Referral Information

How did you hear about us?*

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Please list other adults and the phone # who are authorized to pick up your child/children.*

These will also serve as additional emergency contacts.

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone

Work #

Cell # *

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Contact #2

Contact #2 First Name

Last Name

Type

How can we contact you?

Home Phone

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

Which days of the week do hope to attend? You will get a call or email to confirm availability.*

Special Needs*

Allergies*

Benedryl dose for your child's weight per your doctors recommendation in case of emergency*

Primary Doctor*

You must provide immunization documentation*

Please click on the Search button below, then choose the class your child would like to attend. Please be sure to choose each day of the week you would like your child to attend. Please understand that once registration is complete the days your child attends may not be the days you picked. We attempt to give all families the original days they chose but children are given the days available. The director fills each day as the children are registered and the registration fees are paid. Each class is capped at a daily number of students, so although you may be able to register for the day the day may already be full. The Jackrabbit system lets all spots fill until all days for the entire week are full so some days end up over filled. The director will contact you to confirm space availability.

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

Which days of the week do hope to attend? You will get a call or email to confirm availability.*

Special Needs*

Allergies*

Benedryl dose for your child's weight per your doctors recommendation in case of emergency*

Primary Doctor*

You must provide immunization documentation*

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

Which days of the week do hope to attend? You will get a call or email to confirm availability.*

Special Needs*

Allergies*

Benedryl dose for your child's weight per your doctors recommendation in case of emergency*

Primary Doctor*

You must provide immunization documentation*

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

Which days of the week do hope to attend? You will get a call or email to confirm availability.*

Special Needs*

Allergies*

Benedryl dose for your child's weight per your doctors recommendation in case of emergency*

Primary Doctor*

You must provide immunization documentation*

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

Which days of the week do hope to attend? You will get a call or email to confirm availability.*

Special Needs*

Allergies*

Benedryl dose for your child's weight per your doctors recommendation in case of emergency*

Primary Doctor*

You must provide immunization documentation*

Enroll in Classes

Select Class

Add Another Student