Bethany Church Preschool Registration (2026/2027)

Your name *

Last name

Email address *

Today's date *

Child's name *

Name to be used/written at school / any nicknames

Gender *

male

female

Birthday

Age as of September 1 *

Address *

HomeWorkOther

Country

Country

Street address

Apt/unit/box (optional)

City

State

Postal code

Parent 1 Name *

Parent 1 Employer *

Phone number *

Phone type

MobileHomeWorkOther

Parent 2 Name *

Parent 2 Employer *

Phone number *

Phone type

MobileHomeWorkOther

Emergency contact *

Please list someone other than yourself

Phone number *

Phone type

MobileHomeWorkOther

Other children in the family (include ages) *

Child's physical or emotional handicaps (if any) *

Experiences away from parents (church school, play groups, etc.) *

Do you have a special talent that you could share with the children? If yes, please describe. *

Child's doctor *

Phone number *

Phone type

MobileHomeWorkOther

Kindergarten your child will attend (include year) *

IMPORTANT: Please list all allergies or medical information that could be useful during school times. *

Please feel free to explain any information concerning your child that could help to make school more comfortable. *

I give my permission for my child to go on field trips: *

Yes

No

I give my permission for my child to have his/her picture taken during class activities: *

Yes

No

Within two (2) months or any time during the school year, if your child fails to adjust, we reserve the right to withdraw your child from preschool. By checking the box, you give your consent. *

Please submit the $75.00 non-refundable registration fee.

Please submit a check or money order made out to Bethany Church Preschool in one of the following ways:
1. Mail to the Church
2. Place your money in an envelope marked "registration" with your child's name and place in your child's school bag.
3. Hand check or money in a MARKED ENVELOPE to your teacher.

Once your fee is received, your spot will be confirmed. If a spot is not available, your check will be returned.

Thank you for your interest!

Once you submit this form, your application will be reviewed by the preschool director. Please submit your registration fee of $75.00 as soon as possible. Once your form AND money are received, you will receive an acceptance letter via the email address you provided. Additional information will be sent this summer to anyone whose registration has been confirmed.

Submit

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