PreSchool 2025-2026 Registration Form Step 1 of 2 50% 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, 2025Children 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 NumberFather'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 NumberIf 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)NamePhone Number Add RemovePersons 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)NameAddress Add RemovePermission 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. Δ
