Jasper United Methodist Church Preschool

2025-2026 Application for Admission

PreSchool 2025-2026

Registration Form

Step 1 of 2

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Registration Form 2025-2026

Please complete all questions. The Form will not allow you to move to a new section until all (Required) questions are answered.

Registration Fee $100.00 Activity Fee $50.00

Please Select(Required)

Mothers Morning Out

Tiny Tots

2 year olds (Three day)

2 year olds (Five day)

3 year olds (Three day)

3 year olds (Five day)

Pre-K

Kindergarten

Child's Full Name(Required)

Name Child Goes By

Date of Birth(Required)

MM slash DD slash YYYY

Child's Age as of September 1, 2025

Children must be of age by September 1st for the class they are entering. Children entering the 3 year old classes should be fully potty trained.

Gender: Male or Female(Required)

Male

Female

Child's Living Arrangements(Required)

Both Father & Mother

Father

Mother

Other

Child's Primary Address (including city and Zip code)(Required)

Street Address Address Line 2 City ZIP Code

Father's Name

First Last

Father's Address (if different from child)

Street Address Address Line 2 City ZIP Code

Father's Email Address

Father's Cell Phone and Work or Other Number

Father's Place of Employment

Mother's First and Last Name

First Last

Mother's Address (if different from child)

Street Address Address Line 2 City ZIP Code

Mother's Email Address

Mother's Cell Phone and Work or Other Number

If there is a separation or divorce in the family, please describe the custody agreement.

Emergency Contacts/Authorized Individuals To Whom Child May Be Released. You may list up to 6 individuals. Please include phone numbers.

click the + sign to add another individual (add up to 6 individuals)

Name

Phone Number

 

Add Remove

Persons NOT AUTHORIZED to pick up your child.

Are there any family situations or special concerns/needs that JUMC Preschool should know in order to best care for your child?

Does the child have any siblings that currently attend JUMC Preschool? If yes, please list name and ages.

Child's Health Information

Please complete all questions. The Form will not allow you to move to a new section until all questions are answered. Please type N/A if a question is not applicable.

List any allergies or medical conditions your child may have

List any medications your child takes regularly

Any other information we may need to know about your child.

Tuition

The tuition at JUMC Preschool is a yearly tuition. You can pay the full amount by August 15th and receive a 10% discount, or you can choose the monthly payment option. The monthly option is broken down into 10 payments. The amount does not change (unless there is a late fee added) for each month. This does include any months that may be considered "short months" such as December and May.

Spaces will be limited; therefore registration and activity fee should be paid as soon as possible. Spaces are filled on a first come, first serve basis.

Please check that you have read information about tuition(Required)

I have read

Information about forms of payments accepted at JUMC Preschool

You will receive a code for your child to use when making tuition payments (you will get on the first day of school). Please make sure to include this code on any form of payment.

Forms of payments:

ONLINE - jasperumc.org preschool tab, pay online tab, under the optional memo

use the code provided and your childs first and last name. example: 10-100 Sally Smith

CASH/CHECK - pay at the preschool, you can give the payment to Donna or Lisa, or put in the lockbox outside their office door. Please include your child's code and name.

Name and Address of anyone paying tuition for your child (please include your information as well.) This is to ensure that everyone will get the information needed for tax purposes.

click the + sign to add another person (add up to 6 individuals)

Name

Address

 

Add Remove

Permission to Photograph(Required)

I give my child permission to be photographed for any school related newsletters, activities, or websites.

Yes

No

Please upload a copy of your child's immunization records. If unable to do so, please make copies and turn into the Preschool or you can email to: dooley@jasperumc.org

Drop files here or Select files

Max. file size: 64 MB, Max. files: 10.

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