Online Registration Form The following online registration form may be used but payment must still be mailed to the preschool or dropped off for your child’s registration to be finalized. Click the links below to download each form, should you need a copy. 2025 Registration Information Physicians Form & Allergic Reaction Action Plan Form Child's Name * First Name Last Name Child's Middle Name * Name to be Used in School and on School Work * Child's Gender * Male Female Child's Date of Birth * MM DD YYYY Street Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Preferred Email * Mom/Guardian Name * First Name Last Name Mom/Guardian Cell Phone Number * (###) ### #### Mom/Guardian Workplace * Mom/Guardian Email * Dad/Guardian Name * First Name Last Name Dad/Guardian Cell Phone Number * (###) ### #### Dad/Guardian Workplace * Dad/Guardian Email * Class Selection * M/W 2 Year-Old Class T/TH 2 Year-Old Class T/W/TH 3 Year-Old Class M-TH 3 Year-Old Class M-TH 4 Year-Old Pre-K M-TH 4/5 Year-Old TK Who other than a parent can we call in case of an emergency? Emergency Contact Name * First Name Last Name Emergency Contact Relationship to Child * Emergency Contact Phone Number * (###) ### #### Physician Information Physician Name * First Name Last Name Physician Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Physician Phone Number * (###) ### #### Dentist Information Dentist Name * First Name Last Name Dentist Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Dentist Phone Number * (###) ### #### In order for your child to receive optimal care while at preschool, please describe any special needs, health challenges, developmental delays, therapies, allergies, eating habits, fears, etc. your child's teacher should be aware of: * If enrolled, I fully understand that the Christian faith and philosophy are the foundation of the Bethel Presbyterian Church Weekday Preschool and are incorporated into our daily curriculum. By electronically signing below, I am agreeing to the aforementioned statement. Authorized Signature * By typing your name below, you are electronically signing this application and agree that your typed name is the legal equivalent of your handwritten signature. Please acknowledge your signature above by clicking the statement button below * I agree that my typed name above will serve as my electronic signature. Date Submitted * MM DD YYYY Current or Past Enrollment Select one option below * Returning Student New Student Bethel Church Member Former BWP Family How did you hear about our preschool? * Did someone refer you? If so, please share their name with us! Important Information for All Parents I understand that in order for this enrollment to be complete and for my child to be admitted to the preschool, I must sign below acknowledging: -Current families, Bethel Church members, and returning alumni families will submit a $100 registration fee and first tuition payment with this registration form. -Families new to the preschool will submit a $100 registration fee and first tuition payment upon notification of acceptance into the preschool -Monthly tuition payments are as follows: ---M/W & T/Th 2 year-olds: $255 ---T/W/Th 3 year-olds: $300 ---M-TH 3 year-olds and Pre-K 4 year-olds: $355 ---M-TH TK 4/5 year-olds: $375 -Immunizations are required for all children and must be up to date. -Letters of religious or medical exemptions will not be accepted -Immunization Records, Physicians Statement and $100 Activity Fee are due to the Director by August 1st. -Registration and first month tuition is non-reundable in all circumstances. Authorized Signature * By typing your name below, you are electronically signing this application and agree that your typed name is the legal equivalent of your handwritten signature. Date Submitted * MM DD YYYY Emergency Treatment Consent In the event of an illness or an accident which requires immediate medical attention at a time when a parent cannot be located, I give permission for Michelle Koslick, Director of the Bethel Presbyterian Church Weekday Preschool or other Preschool personnel designated by the director, to authorize such treatment. I will not hold Bethel Preschool personnel or medical personnel libel. This is done with the understanding that every effort will be made to contact the parents, the child's emergency contact, and the child's physician. Authorized Signature * By typing your name below, you are electronically signing this application and agree that your typed name is the legal equivalent of your handwritten signature. Date Submitted * MM DD YYYY 3 & 4 Year-Old Class Parents - Please Sign Below Acknowledging That... I understand that my child must be toilet trained to attend school. This includes not using pull-ups and being able to take care of bathroom needs independently. Please refer to page 11 of the parent handbook for more information about this policy Authorized Signature By typing your name below, you are electronically signing this application and agree that your typed name is the legal equivalent of your handwritten signature. Date Submitted MM DD YYYY Thank you!
