REGISTRATION FOR PREPARED CHILDREN

Programs and Classes

Child First Name:

Child Last Name:

Birthdate:

Year   Month  Day

Age:

CLASS SELECTION

Enrollment fees cover the registration process and all supplies for the selected classes. The enrollment fee for the first class selected is $65.00. Additional classes can be added for enrollment fees of $30 each. This does not include the class fees themselves.

Kindergarten Readiness Classes

Monday Morning

Mon. 8:00-8:50
Mon. 9:00-9:50
Mon. 10:00-10:50
Unselected

Tuesday Morning

Tues. 8:00-8:50
Tues. 9:00-9:50
Tues. 10:00-10:50
Unselected

Wednesday Morning

Wed. 8:00-8:50
Unselected

Friday Morning

Fri. 9:00-9:50
Fri. 10:00-10:50
Unselected

Saturday Morning

Sat. 9:00-9:50
Sat. 10:00-10:50
Unselected

Tuesday Afternoon

Tues. 1:30-2:20
Tues. 2:30-3:20
Tues. 4:30-5:20
Unselected

Spanish Enrichment Classes

Monday Morning

Mon. 10:00-10:50: Preschool (3-5)
Mon. 11:00-11:50: Preschool (3-5)
Unselected

Tuesday Morning

Tues. 10:00-10:50: Preschool (3-5)
Tues. 11:00-11:50: Preschool (3-5)
Unselected

Monday Afternoon

Mon. 1:30-2:20: Preschool (3-5)
Unselected

Tuesday Afternoon

Tues. 3:00-3:50: Elementary (K-2)
Tues. 4:00-4:50: Elementary (3-5)
Unselected

Handwriting Enrichment Classes

Wednesday Morning

Wed. 9:00-9:50: Kindergarten
Wed. 10:00-10:50: Grades 1-2
Wed. 11:00-11:50: Grades 3-4
Unselected

Wednesday Afternoon

Wed. 3:00-3:50: Kindergarten
Wed. 4:00-4:50: Grades 1-2
Wed. 5:00-5:50: Grades 3-4
Unselected

Parent/Legal Guardian First Name:

Parent/Legal Guardian Last Name:

Home Phone:
xxx-xxx-xxxx

Cell Phone:
xxx-xxx-xxxx

Mom's Work Phone:
xxx-xxx-xxxx

Dad's Work Phone:
xxx-xxx-xxxx

Address:

Address 2:

City:

State:

Zip Code:

Email Address:

School Child Attends:

Rising Grade in School:

Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade

Does child have allergies?:

Yes

No

If "yes" please list all allergies:

Describe your Child's Strengths:

Describe your Child's Interests:

Is your child able to sit still and read?

Yes

No

If 'yes', for how many minutes?:

Is your child able to sit still while you read to him or her?

Yes

No

If 'yes', for how many minutes?:

Additional Information about your child you think we should know:

Please mark one box to answer each question:

Does your child play well with others?

Yes

No

Sometimes

Does your child play well alone?

Yes

No

Sometimes

Does your child accept when things do not go his or her way?

Yes

No

Sometimes

Does your child have difficulty following directions?

Yes

No

Sometimes

Does your child function well with distractions?

Yes

No

Sometimes

Does your child express him or herself freely?

Yes

No

Sometimes

Does your child offer to assist other children?

Yes

No

Sometimes

Does your child play well without adult support?

Yes

No

Sometimes

Does your child handle disappointment well?

Yes

No

Not Sure

Does your child express him or herself through language?

Yes

No

Sometimes

Does your child express him or herself through art?

Yes

No

Not Sure

Does your child express him or herself through movement?

Yes

No

Not Sure

Does your child follow routines in the home?

Yes

No

Sometimes

I understand that by checking this box I have read and accept the enrollment terms and conditions.
(For a printable PDF of Terms & Conditions Click HERE)

If you need more information email us or call 704-215-4950.