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Registration for 2018-2019 School Year

Open Enrollment will begin on February 5, 2018.

Classes are expected to fill up very quickly for next school year, so please don't wait to get information. We highly recommend that you request information and/or schedule to come in for a tour prior to February 5th so you are ready to register on that day. Please contact our Preschool Director, Megan Gieger at preschool@thechurchat.org or by calling 360.668.4180 X1008.

*NEW* Half-Day Kindergarten (Mon-Fri)

For children who will be 5 years old by August 31st. 4 year olds with Sept/Oct birthdays, who have been enrolled previously in a preschool program, please inquire with the director about Kindergarten registration.

Child First and Last Name

Child's Gender

Child's Birthdate

Class Choice

Street Address

City

State

Zip Code

Mother/Guardians Full Name

Mother/Guardians Cell Phone

Mother/Guardians Work Phone

Father/Guardians Full Name

Father/Guardians Cell Phone

Father/Guardians Work Phone

Child Release Information

In addition to the above listed parents/guardians the following three people are authorized to pick up my child and/or are to be contacted if the parent/guardian is not reachable in the event of an emergency. Please include name, relationship to child and contact phone number.

Names and Ages of Siblings

Information regarding your child's personality, needs, habits etc... we should know?

Has your child had previous experience in preschool/childcare? If so, where and what length of time?

Please identify the most important qualities or experiences you would like the staff to provide for your child

Pediatrician's First and Last Name

Pediatrician's Phone Number

Pediatrician's Full Street Address

Dentist's First and Last Name

Dentist's Phone Number

Dentist's Full Street Address

Medical Insurance Company

Child Allergies/Conditions

Child Medication Needs

Has Your Child had the Chicken Pox?

Parent Agreement

Please check below that you have read each section and that you agree to the policies and procedures stated. I wish to enroll my child at The Preschool at Maltby for the 2018-2019 school year. I understand that any/all registration/material fees are without exception non-refundable and non-transferable at the time of payment and these fees do not apply to any month’s tuition. I also understand that the receipt of these fees guarantees my child’s enrollment for the 2018-2019 school year. Without receipt of this payment The Preschool at Maltby has the right to relinquish my child’s spot to another applicant. I also agree to make ten additional tuition payments in the amount of $175 (for the Tues/Thurs class) and/or $225 (for the Mon/Wed/Fri class) and /or $400 (for the half-day Kindergarten class) on the 1st day of the month August 2018-May 2019. Tuition is considered past due if received after the 10th day of the month for which it is due and a late fee of $20 may be added to my child’s tuition account. If my tuition account becomes two months past due, I understand that my child may be withdrawn from enrollment. I understand that the Preschool at Maltby reserves the right to withdraw a student from enrollment and/or to change classes offered at any time for any reason. I attest that I am the aforementioned child’s parent/legal guardian and that I have the legal custody rights to make decisions on behalf of this child, and as such I agree that where the Preschool at Maltby has acted in good faith to comply with an accident and/or illness procedure, it shall not be liable for any accident and/or illness to this child, any and all liability as might otherwise exist being expressly waived by the parent. It is mutually agreed that in the event of an accident or illness of my child while in the care of the Preschool at Maltby, the Preschool at Maltby shall use it’s best efforts to contact the parent(s) immediately. In the event the parents are not immediately available, the Preschool at Maltby is authorized to secure such care as the situation may reasonably warrant. I authorize the Preschool at Maltby to administer emergency treatment, to include first aid and CPR by a qualified staff member of the Preschool at Maltby. I further authorize and consent to medical, surgical and hospital care when deemed necessary to safeguard my child’s health. I also give permission for my child to be transported by ambulance to an emergency center for treatment and agree that I will pay physicians and hospital bills. I also agree to read and abide by all of the policies in the parent handbook, which is to be provided by the Preschool at Maltby. I grant permission for my child’s name, our parent names, home address, phone number and email address to be included on the class directory, which may be distributed to other parents in my child’s class. I also give permission for my child to be photographed or videoed, understanding that these photos/videos will be used for school purposes only and the identity of all children will be kept private at all times.

How did you hear about our Preschool?

If you were referred to us, who referred you?

First and last name please

Best address to email you at