Bethany Lutheran Preschool &...
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Transcript of Bethany Lutheran Preschool &...
Bethany Lutheran Preschool & MDO 9101 Lamar Ave, Overland Park, Kansas 66207 913.648.2228 Extension 117 [email protected]
SUMMER ENROLLMENT REGISTRATION 2018
Student Information Date_______________________
Child’s Name_________________________________________________________ Male_______ Female______
First Last
Photo Release
__Yes. I grant permission for my child’s photo to be taken, for intended use of display on bulletin boards,
school videos and/or newsletters. OR
__No. Please do NOT take or use any photos of my child.
Preferred Name or Nickname _________________________ Birthdate: Month_____Day____Year_________
Is Child Toilet Trained? Yes ___ No ___
Parent Names_________________________________________________________________________________
Home Address_____________________________City_______________________ State_______ Zip _________
Home Phone ____________________Cell Phone(s) __________________(mom) _____________________(dad)
Email(s) 1st choice__________________________________ 2nd choice___________________________________
(To receive information from your child’s teacher and or other pertinent information about school)
Do you have a faith community? Yes____No____If yes, name_________________________________________
How did you learn about Bethany? _______________________________________________________________
Child’s Doctor ____________________________________________ Phone______________________________
Does the child have any allergies? Yes___ No___If yes, please list______________________________________
Are there any health concerns? Yes___No___ If yes, please explain ____________________________________
Does the child have any specialized needs? Yes___No___If yes, please describe them _____________________
_____________________________________________________________________________________________
May we include your contact information for the classroom directory? Yes______ No______
Emergency Contacts & Relationships:
(Persons authorized to pick up this child other than parents or guardians)
Name____________________________________Relationship_____________________Phone_______________
Name____________________________________Relationship_____________________Phone_______________
Name____________________________________Relationship_____________________Phone_______________
Office Use: Received_________________ Start Date ______________________ Class & Day____________________________________
Paid 1/2 ___ Paid in Full ___ Applied 1/2 to FACTS ___ PIF through FACTS___ Entered in Procare ________
Email Added_____________
If child attended Bethany during the 2017-2018 school year, which class did they attend?
MDO: Walkers (12-30 months) __ Runners (24-36 months) __ Movers & Shakers (30 month's-4 yrs) __
BP/KP: Beginners Preschool __ Kindergarten Prep __ Multi-Age Progressive __
Select Days Below:
June
06/05 __
Tue
06/06 __
Wed
06/07 __
Thu
June
06/19 __
Tue
06/20 __
Wed
06/21 __
Thu
June
06/12 __
Tue
06/13 __
Wed
06/14 __
Thu
June
06/26 __
Tue
06/27 __
Wed
06/28 __
Thu
July
07/10 __
Tue
07/11 __
Wed
07/12 __
Thu
Total of _____ days
I have read and agree with this tuition agreement.
Parents’ Signature _____________________________________Date _________________
Application process is not finalized until all items listed below are completed and returned to the Preschool/MDO
office.
__ Completed Application Forms
__ Completed Health Forms
__ Half Paid
__ Paid in Full
July
07/03 __
Tue
07/05 __
Thu
07/06 __
Fri
No class on Wednesday this week
due to Independence Day, class
will be on Friday instead!
2018 Summer Registration Options and Costs:
June 5 - July 12 ~ Tuesdays, Wednesdays and Thursdays
9 a.m. to 3 p.m.
1 - Enroll in entire session, one day per week (T or W or Th)
$264 total (1/2 due at enrollment, remaining due first day)
2 - Enroll in entire session, two days per week (T/W or W/Th or T/Th)
$519 total (1/2 due at enrollment, remaining due first day)
3 - Enroll in entire session, three days per week (T and W and Th)
$745 total (1/2 due at enrollment, remaining due first day)
4 - Enroll in specific day(s)
$50 (full payment due at enrollment)
Financial Admission
Half due upon enrollment in the form of cash or check. Residual amount due first day of attendance. Sorry, due to
the nature of the camp, enrollment fees are non-refundable. Families enrolled in FACTS may pay ½ or the full
amount through their FACTS account and charged for the remainder of the 2016-2017 school year.
