|
Mother (or
guardian): |
|
|
Name:
_____________________ |
Employer:
______________________ |
|
Address:
____________________ |
Address:
_______________________ |
|
City/St/Zip:
__________________ |
City/St/Zip:
_____________________ |
| Phone:
____________________ |
Phone:
_________________________ |
|
Cell Phone:
________________ |
Driver’s Lic.#:
____________________ |
| |
|
|
Father (or
guardian): |
|
|
Name:
___________________ |
Employer:
_______________________ |
|
Address:
__________________ |
Address:
________________________ |
|
City/St/Zip:
_______________ |
City/St/Zip:
______________________ |
|
Phone:
__________________ |
Phone:
_________________________ |
|
Cell Phone:
_______________ |
Driver’s Lic.#:
___________________ |
| |
|
| Has this child attended
preschool before? Yes __
No __ |
| If yes, where?
____________________________________________ |
| Have you applied to an OPS
program? Yes __ No
__ |
| |
|
| Please check the class for
which you are enrolling your child: |
| __ Class A
(Mon./Wed./Fri. 9:00 - 11:30 a.m.)
$99.00 per month |
| __ Class B (Tues.
/Thurs. 9:00 - 11:30 a.m.) $79.00 per month |
| __ Class C (M - F
9:00-11:30 a.m.) (4-5 year olds only)
$178.00 per month |
| |
|
| Early registration is
important. A non-refundable fee of
$25.00 is required with this form to ensure
a spot for your child. This is an
annual fee, which covers registration and
liability insurance costs. |
| |
|
| Enrollment Agreement: |
| I wish to enroll my child in
the Miracle Hills Community Baptist Church
Child Care program indicated above. I
understand that a full year's tution has
been divided into nine equal payments for my
convenience and that I am expected to meet
my monthly obligation on or before the first
day of class each calendar month regardless
of a student's illness, vacations, or
holidays. I understand that my child
will not be allowed to attend if I am more
than five days late with my payment.
Further, I understand that there is a one
dollar per minute penalty if I am late to
pick up my child. Additionally, I
understand that Miracle Hills is a Christ
centered church and as such part of
the curriculum will include familiarization
with the Christian faith unless specific
arrangements are made by me with the staff. |
| |
|
| Signed:
__________________________ |
