Child's Legal Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Child's Date of Birth *

MM

DD

YYYY

Child's Gender *

Male

Female

Classes *

Students will receive a lunch every day included in the cost of preschool tuition for the 2025/2026 school year.

Pre-K 2 (4 by Aug 1) Mon-Fri, 9:00am-12:00pm, AND Tues, Thurs, 9:00am-3:00pm, $312 per month OR $78/wk

Kindergarten Prep (for children planning to attend Kindergarten in Fall 2026) Mon-Fri, 9:00am-3:00pm $456 per month OR $114/wk

3 Day Beginner (3 by Aug 1) MWF, 9:00 am- 12:00pm $220/mo. OR $55/wk.

Pre-K 1 (4 by Aug 1) Mon-Fri, 9:00am-12:00pm $220/mo. OR $50/wk.

Will you need before/aftercare? *

Yes

No

If yes, which of the following will you need? *

Pre-K 2: $133/wk

Kindergarten Prep: $100/wk

N/A

Does the child have a mother? *

Yes

No

Mother's Name *

First Name

Last Name

Does the mother live with the child? *

Yes

No

Mother's Date of Birth *

MM

DD

YYYY

Mother's Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Mother's Phone Number *

(###)

###

####

Is this child's mother employed? *

Yes

No

Mother's Employer's Address *

N/A if not applicable

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Mother's Work Number *

(###)

###

####

What's the best way to contact the mother? *

Cell Phone

Work Phone

Email

Does the child have a father? *

Yes

No

Father's Name *

N/A if not applicable

First Name

Last Name

Father's Date of Birth *

MM

DD

YYYY

Does the father live with the child? *

Yes

No

Father's Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Father's Phone Number *

(###)

###

####

Is the father employed? *

Yes

No

Father's Employer's Address *

N/A if not applicable

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Father's Work Phone *

(###)

###

####

What is the best way to contact father? *

Cell Phone

Work Phone

Email

Marital Status *

Single

Married

Divorced

Legally Separated

Other

Does the child live with the person listed above? *

Yes

No

Who is financially responsible for the child's tuition? *

Custodial Mother

Custodial Father

Other

Financially Responsible Person's Name

First Name

Last Name

Financially Responsible Person's Date of Birth

MM

DD

YYYY

Financially Responsible Person's Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Is the person responsible for tuition employed?

Yes

No

Financially Responsible's Employer's Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Financially Responsible's Phone Number

(###)

###

####

Financially Responsible's Work Number

(###)

###

####

Best way to contact this person

Cell Phone

Work Phone

Email

Emergency Contact *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Work Phone *

(###)

###

####

Best way to reach emergency contact *

Cell Phone

Work Phone

Child's Physician *

First Name

Last Name

Physician's Phone Number *

(###)

###

####

Does your child have any siblings? *

Yes

No

Sibling's Name

First Name

Last Name

Date of Birth

MM

DD

YYYY

Sibling's Gender

Female

Male

Sibling 2's Name

First Name

Last Name

Sibling 2's Date of Birth

MM

DD

YYYY

Sibling 2's Gender

Female

Male

Sibling 3's Name

First Name

Last Name

Sibling 3's Date of Birth

MM

DD

YYYY

Sibling 3's Gender

Female

Male

Does anyone else live in the house with the child? *

Yes

No

Person's Name

First Name

Last Name

Person's Gender

Female

Male

Person's Date of Birth

MM

DD

YYYY

Do you attend a church regularly? *

Yes

No

Would you like more information about New Haven United Methodist Church? *

Yes

No

Payment of the registration fee is nonrefundable *

I agree

Tuition is due by the 15th of each month, beginning September 15th. We will set up an autopayment for tuition. If you choose to decline autopay, you will be charged a 5% increase to your child’s tuition. * Our Preschool Prices are subject to change at the beginning of each School Year (September 2025) *

I agree

I will keep my child home if they are showing signs of illness or communicable disease. *

I agree

I will pick up my child promptly by the end of class each day. If late, I will pay a late student pick-up fee. *

I agree