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Registration Form

Or, if you prefer, you can download a PDF of this form to print out and mail/fax in. Download Student Registration Form Here

Registration Form: Student Information

Child's Name:



Class Desired:

3 yr Nursery (select days: Mon/Tues -or- Thurs/Fri)
4 yr Nursery (select days: Mon-Wed -or- Wed-Fri AM PM)
5 yr Pre K (select days attending: M T W Th F)
Kindergarten Academy Wrap to WSSD
Full Day Program (select days: attending M T W Th F)
Birth Date: Current Date:
**** Please return registration with a $25 non-refundable registration fee.

PARENTS/GUARDIANS Address correspondence to:









Unlisted










Unlisted


OTHER EMERGENCY CONTACT





MEDICAL INFORMATION












***ALL PHYSICAL AND MEDICAL FORMS FOR KINDERGARTEN WILL BE SENT TO YOU IN A CONFIRMATION PACKET IN THE SPRING.***

Please complete the following information to better serve your child in the classroom setting. Thank you.

Has your child been exposed to babysitters or left with a relative or friend at all?


Is your son/daughter an only child and/or have they had many playmates their age?


Have you or has someone else read books on a regular basis to your child?


Has your child had any exposure to develpment of numbers or letters, by either recognition, sound, or actual writing?


Is there anything you feel your child's teacher should know about your child? If so, please fill in below.


***ALL PHYSICAL AND MEDICAL FORMS FOR KINDERGARTEN WILL BE SENT TO YOU IN A CONFIRMATION PACKET IN THE SPRING.***

How did you hear of Little Hands Nursery & Kindergarten School?

(where)
(family)


Thank you!

I understand that I am responsible for paying tuition by the 1st of each month, and thereafter, a $10 late fee will be assessed. I agree to pay late fees if I am late with payments. Tuition is payable each month through the end of the school year. I also understand that a pick up late fee will be assessed at $1 per minute if I am more than 5 minutes late for pick up at the end of my child's session (note: please call with any unforeseen emergency situation).