PRESCHOOL REGISTRATION 2023 - 2024

REGISTRATION INFORMATION

Our preschool program provides an enriching early childhood experience, centering on the emotional, social, physical, self-help, and academic development of a child. We recognize the importance of play for healthy brain development and the joy in learning students experience from our engaging teachers and rich environment. Students receive a session of swimming lessons at no additional cost and get to enjoy the amenities of our facility including the indoor playground and wood gym as part of their daily routine.

I am signing child up for: *

Sprouts (33mo. - 3yrs) TH/F | 8:30 - 11:00a | $100

Stepping Stones (4 - 5yrs) M/T/W | 8:30 - 11:00a | $137

Building Blocks Pre K (Must be 4yrs by 9/1/23) M - F | 12:00 - 2:30p | $200

STUDENT INFORMATION

As of September 1, 2023 child will be: *

Will you apply for Rainbow Route bussing? *

Yes

No

Are you interested in applying for a preschool scholarship to help with tuition costs? *

Yes

No

Student's Full Name *

Date of Birth * +

Current Address *

City *

State/Province *

Zip/Postal Code *

PARENT/GUARDIAN INFORMATION

Name of Parent/Guardian 1 *

Parent/Guardian 1 - Cell Phone *

Name of Parent/Guardian 2

Parent/Guardian 2 - Cell Phone

Parent/Guardian 1 - Employer *

Parent/Guardian 1 - Employer Phone *

Parent/Guardian 2 - Employer

Parent/Guardian 2 - Employer Phone

Parent/Guardian 1 - Email Address *

Parent/Guardian 2 - Email Address

Does child have any allergies or medical conditions? *

Yes

No

If yes, please describe *

REGISTRATION FEE - $50

$50 non-refundable fee required with submission. By inputing your financial information, you authorize the YMCA at ACRC to withdraw a one-time $50 charge. Registrations will not be accepted without payment. Financial assistance is NOT applicable to registration fees.

Payment Type *

EFT (checking/savings)

Credit/Debit Card

Name on Card *

Credit Card Type *

Credit Card Number *

Expiration Date (mm/yy) *

Billing Address *

Billing Address Line 2

Billing City *

Billing Zip Code *

Name on Account *

Bank Name *

City of Bank *

Zip Code of Bank *

Bank Routing Number *

Bank Checking Number *

SIGNATURE

Parent/Guardian Signature *

clear