Professional Documents
Culture Documents
Registration
Good Shepherd Lutheran Church
320 South Pearl St., PO Box 690, Canandaigua, NY 14424
585-394-2760
Information
Childs Name:
Mothers Name:
Fathers Name:
Childs Home Address: ________________________________________
_____________________________________________zip
Age:(as of Dec.1, 2015)_____________Date of Birth:
Mothers phone: ___________________ work phone:
Fathers phone: ___________________ work phone:
E-mail address: ______________________________________________
Emergency name: ___________________________ phone:
Program
All classes run from 9:00 to 11:30 and are open to three, four, and five year olds.
Choose the days you would like your child to attend:
_____ Mon.
_____Tues.
______Wed.
______Thurs.
______ Fri.
Tuition
2-day program - yearly tuition,
3-day program - yearly tuition,
4-day program yearly tuition,
5-day program yearly tuition,
Registration
$25 registration fee (This fee is separate from tuition and is non-refundable.)
Requirements
________ Health & Immunization records required before starting preschool
________ Child is potty trained
Parental Involvement
I am willing to improve my childs program and defray the cost by:
__________ supplying snack (once per month)
__________ participating as a parent helper (any time)
__________ cleaning the preschool room and toys (2x per year)
I understand that tuition payments are needed on a timely basis, and a late fee will be added after a
10 day grace period.
Parent signature:____________________________________date:_________________
You are welcome to visit the classroom at any time. Please feel free to call 394-2760 if you have
any questions. God will guide us in a great year of learning and growing!