New Life Preschool & After School Care Online Registration

Registration

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Welcome to New Life Care! Use this form to register for our 2024 Summer Care program and our After-School Care for 2024-2025 Text Ketrah Holley at 251-802-8542 for assistance or for more info. She will call you back as soon as possible. Also, please note that the system will not automatically run your card for the registration fee. You will need to do that manually.

* 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

Emergency Contact Info (Not Contact #1 or #2)*

Health Insurance Carrier

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

Who is your employer?

Employer

Employer Phone

Employer Notes

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

Who is your employer?

Employer

Employer Phone

Employer Notes

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size*

School*

Grade Level*

Disabilities*

Special Needs*

Allergies*

Medications*

Primary Doctor

For Summer Care 2024- Please select your child's current grade level during the 2023-2024 school year.

TUITION FEES:

Daily Tuition Fee is $40 per day for the first child, then $35 a day for each additional sibling.

*You will be asked to fill out a form with the days/weeks that your child will be attending as we get closer to the summer. This will help us with planning our classes and our staff.

*TUITION FEES WILL BE INVOICED ONTO YOUR ACCOUNT ON FRIDAYS and will be due by Monday morning.

A non-refundable REGISTRATION FEE WILL BE $100.00 FOR EACH CHILD FOR SUMMER CARE due at at the time of registration. Max Fee per family is $250.00 This fee includes 1 t-shirt per child to be worn on field-trips and a Liability Insurance fee.

There will also be an ACTIVITY FEE that will cover all of the field-trips this summer. This will invoiced onto your account after you have submitted your registration forms. This fee will be due 1 week before summer care begins and is non-refundable. Fee amounts are still TBD and will be posted as soon as all the details for activities are in place. You will be asked to sign a permission form at the time the activity fee is due. This form will serve as permission for all the activities at New Life this summer. Field-Trips are always optional, so you can choose to opt out of the activity fee. I will not be able to let parents pay for individual field-trips. I will make exceptions for 3 reasons only.

1. Your child has to attend the reading camp at the local elementary school. I will deduct the cost of any field-trips they will miss during those 3 weeks.

2. You have a custody agreement where you are required to split time during the summer with the other parent and that parent does not have the child enrolled at New Life this summer during their time.

3. Your child has special needs or a physical disability that prevents them from participating in certain activities involved on the fieldtrip.

For After-School Care- Please enroll your child in the class for the school they attend. Also, please be sure that you include their age and grade level. Registration Fees for After-School Care will be due by March 31, 2024

Enroll in Classes

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size*

School*

Grade Level*

Disabilities*

Special Needs*

Allergies*

Medications*

Primary Doctor

For Summer Care 2024- Please select your child's current grade level during the 2023-2024 school year.

TUITION FEES:

Daily Tuition Fee is $40 per day for the first child, then $35 a day for each additional sibling.

*You will be asked to fill out a form with the days/weeks that your child will be attending as we get closer to the summer. This will help us with planning our classes and our staff.

*TUITION FEES WILL BE INVOICED ONTO YOUR ACCOUNT ON FRIDAYS and will be due by Monday morning.

A non-refundable REGISTRATION FEE WILL BE $100.00 FOR EACH CHILD FOR SUMMER CARE due at at the time of registration. Max Fee per family is $250.00 This fee includes 1 t-shirt per child to be worn on field-trips and a Liability Insurance fee.

There will also be an ACTIVITY FEE that will cover all of the field-trips this summer. This will invoiced onto your account after you have submitted your registration forms. This fee will be due 1 week before summer care begins and is non-refundable. Fee amounts are still TBD and will be posted as soon as all the details for activities are in place. You will be asked to sign a permission form at the time the activity fee is due. This form will serve as permission for all the activities at New Life this summer. Field-Trips are always optional, so you can choose to opt out of the activity fee. I will not be able to let parents pay for individual field-trips. I will make exceptions for 3 reasons only.

1. Your child has to attend the reading camp at the local elementary school. I will deduct the cost of any field-trips they will miss during those 3 weeks.

2. You have a custody agreement where you are required to split time during the summer with the other parent and that parent does not have the child enrolled at New Life this summer during their time.

3. Your child has special needs or a physical disability that prevents them from participating in certain activities involved on the fieldtrip.

For After-School Care- Please enroll your child in the class for the school they attend. Also, please be sure that you include their age and grade level. Registration Fees for After-School Care will be due by March 31, 2024

Enroll in Classes

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size*

School*

Grade Level*

Disabilities*

Special Needs*

Allergies*

Medications*

Primary Doctor

For Summer Care 2024- Please select your child's current grade level during the 2023-2024 school year.

TUITION FEES:

Daily Tuition Fee is $40 per day for the first child, then $35 a day for each additional sibling.

*You will be asked to fill out a form with the days/weeks that your child will be attending as we get closer to the summer. This will help us with planning our classes and our staff.

*TUITION FEES WILL BE INVOICED ONTO YOUR ACCOUNT ON FRIDAYS and will be due by Monday morning.

A non-refundable REGISTRATION FEE WILL BE $100.00 FOR EACH CHILD FOR SUMMER CARE due at at the time of registration. Max Fee per family is $250.00 This fee includes 1 t-shirt per child to be worn on field-trips and a Liability Insurance fee.

There will also be an ACTIVITY FEE that will cover all of the field-trips this summer. This will invoiced onto your account after you have submitted your registration forms. This fee will be due 1 week before summer care begins and is non-refundable. Fee amounts are still TBD and will be posted as soon as all the details for activities are in place. You will be asked to sign a permission form at the time the activity fee is due. This form will serve as permission for all the activities at New Life this summer. Field-Trips are always optional, so you can choose to opt out of the activity fee. I will not be able to let parents pay for individual field-trips. I will make exceptions for 3 reasons only.

1. Your child has to attend the reading camp at the local elementary school. I will deduct the cost of any field-trips they will miss during those 3 weeks.

2. You have a custody agreement where you are required to split time during the summer with the other parent and that parent does not have the child enrolled at New Life this summer during their time.

3. Your child has special needs or a physical disability that prevents them from participating in certain activities involved on the fieldtrip.

For After-School Care- Please enroll your child in the class for the school they attend. Also, please be sure that you include their age and grade level. Registration Fees for After-School Care will be due by March 31, 2024

Enroll in Classes

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size*

School*

Grade Level*

Disabilities*

Special Needs*

Allergies*

Medications*

Primary Doctor

For Summer Care 2024- Please select your child's current grade level during the 2023-2024 school year.

TUITION FEES:

Daily Tuition Fee is $40 per day for the first child, then $35 a day for each additional sibling.

*You will be asked to fill out a form with the days/weeks that your child will be attending as we get closer to the summer. This will help us with planning our classes and our staff.

*TUITION FEES WILL BE INVOICED ONTO YOUR ACCOUNT ON FRIDAYS and will be due by Monday morning.

A non-refundable REGISTRATION FEE WILL BE $100.00 FOR EACH CHILD FOR SUMMER CARE due at at the time of registration. Max Fee per family is $250.00 This fee includes 1 t-shirt per child to be worn on field-trips and a Liability Insurance fee.

There will also be an ACTIVITY FEE that will cover all of the field-trips this summer. This will invoiced onto your account after you have submitted your registration forms. This fee will be due 1 week before summer care begins and is non-refundable. Fee amounts are still TBD and will be posted as soon as all the details for activities are in place. You will be asked to sign a permission form at the time the activity fee is due. This form will serve as permission for all the activities at New Life this summer. Field-Trips are always optional, so you can choose to opt out of the activity fee. I will not be able to let parents pay for individual field-trips. I will make exceptions for 3 reasons only.

1. Your child has to attend the reading camp at the local elementary school. I will deduct the cost of any field-trips they will miss during those 3 weeks.

2. You have a custody agreement where you are required to split time during the summer with the other parent and that parent does not have the child enrolled at New Life this summer during their time.

3. Your child has special needs or a physical disability that prevents them from participating in certain activities involved on the fieldtrip.

For After-School Care- Please enroll your child in the class for the school they attend. Also, please be sure that you include their age and grade level. Registration Fees for After-School Care will be due by March 31, 2024

Enroll in Classes

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size*

School*

Grade Level*

Disabilities*

Special Needs*

Allergies*

Medications*

Primary Doctor

For Summer Care 2024- Please select your child's current grade level during the 2023-2024 school year.

TUITION FEES:

Daily Tuition Fee is $40 per day for the first child, then $35 a day for each additional sibling.

*You will be asked to fill out a form with the days/weeks that your child will be attending as we get closer to the summer. This will help us with planning our classes and our staff.

*TUITION FEES WILL BE INVOICED ONTO YOUR ACCOUNT ON FRIDAYS and will be due by Monday morning.

A non-refundable REGISTRATION FEE WILL BE $100.00 FOR EACH CHILD FOR SUMMER CARE due at at the time of registration. Max Fee per family is $250.00 This fee includes 1 t-shirt per child to be worn on field-trips and a Liability Insurance fee.

There will also be an ACTIVITY FEE that will cover all of the field-trips this summer. This will invoiced onto your account after you have submitted your registration forms. This fee will be due 1 week before summer care begins and is non-refundable. Fee amounts are still TBD and will be posted as soon as all the details for activities are in place. You will be asked to sign a permission form at the time the activity fee is due. This form will serve as permission for all the activities at New Life this summer. Field-Trips are always optional, so you can choose to opt out of the activity fee. I will not be able to let parents pay for individual field-trips. I will make exceptions for 3 reasons only.

1. Your child has to attend the reading camp at the local elementary school. I will deduct the cost of any field-trips they will miss during those 3 weeks.

2. You have a custody agreement where you are required to split time during the summer with the other parent and that parent does not have the child enrolled at New Life this summer during their time.

3. Your child has special needs or a physical disability that prevents them from participating in certain activities involved on the fieldtrip.

For After-School Care- Please enroll your child in the class for the school they attend. Also, please be sure that you include their age and grade level. Registration Fees for After-School Care will be due by March 31, 2024

Enroll in Classes

Add Another Student

Required Policies and Agreements

(Show-Hide Details)

New Life Summer Care Handbook

I've read the above and agree.

New Life After-School Program Handbook

I've read the above and agree.

E-Payment Policy

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name* April 25, 2024

Questions or Concerns

Comments

Payment Information

Account Information

e-Payment Schedule*

Please fill out CREDIT CARD Payment Method

Credit Card

Card Number *

Exp Month *

Exp Year *

Card Nickname

Name as it appears on card *

Address Line 1

Address Line 2

City

State

Zip*

eCheck/Bank Draft

Bank Name

Account Type

Your Account Name (Your name on your bank statement)

Bank Routing Number (9-digit number)

Account Number