Enrollment Information

Trinity Lutheran MOTHERS’ Morning Out

Registration form Mothers’ Morning Out:

                                               Registration 2020-2021

Child=s Name___________________               Date of Application_________

Nickname____________________________  Birth date_________________

Address________________________               Home Phone____________________

             _________________________                Email _____________________

 Mother’s Name__________________         Work Number_____________

 Occupation______________________        Cell Phone______________________________

 Father’s Name___________________        Work Number_____________

 Occupation______________________        Cell Phone______________

List of siblings, name, ages & school:

 ______________________     ________

 ______________________     ________ ________________

 ______________________     ________

 ______________________     ________ ________________

 ______________________     ________

Religious affiliation_ (name of church)____________________________________

Nearest neighbor of relative in case of an emergency:

Name________________                        Phone____________

Address__

Name__________________________________ Phone_______________

Address___________________________________

_________________________________

Doctor____________________   Phone_____________

Dentist____________________   Phone_____________

In case of an emergency, my child may be taken to _________________

(hospital)   

Food sensitivities____________________________Does your child have asthma?___ inhaler?___

Allergies_____________________________________Does your child have an epi-pen?______

Any important information you would like to share about your child such as habits, likes, dislikes, illnesses_____________________________________________________________

___________________________________________________________________________

I give my permission for the school to administer first aid to my child, ____________

Signed_______________________.

I give my permission for _________________to participate in any class activity or trip during the school year thereby releasing the school from any liability.

Signed________________________Date___________________

Please Check:

 Room B2 years old by September 1:    Monday   Tuesday   Wednesday  Thursday    Friday

Room AUnder 2 years old by Sept. 1:   Monday   Tuesday    Wednesday    Thursday,

2020-2021 School Year

Registration fee due at the time of application $ 25.00

The school year is divided into 4 sessions. Payments are made during the months of September, November, February and April.  Tuition is based on the number of days per week your child participates in the program.  Bills will be posted outside the classroom at the beginning of each session. The fee per day is $33.50 for the first day. The second day is $33.00

Arrival        9:00 A.M.

Dismissal   11:30 A.M.

At dismissal, my child will be taken home by: ________________________________________________________________

At dismissal, we need to see a driver=s license as proof of identification.

The teachers will list the names of people permitted to pick up the child in the classroom.

Signature of parent_______________________________

Signature of director______________________________

Early morning drop off……..8:00 …..FREE

Lunch Bunch…..11:30 to 1:30 …..$10.00

PLEASE BRING A COPY OF YOUR CHILD=S INOCULATION

Does your child receive services from Early Intervention?   Yes         No

If yes, please send us a copy of the IEP……..Thank you

If you currently do not have a home church, would you like a visit with the Pastor of Trinity?   Yes          or             No

Trinity Lutheran Nursery School & Mothers’ Morning Out

Child’s Full Name__________________________________________

Class________________________________

Emergency Contact information:

In the order of notification (list mom as #1)

Name                       Relation                          Phone number

1.___________         __________________        ______________

2.___________         ___________________      ______________

3.___________        ____________________     _______________

People Permitted to pick up your child from school:

Name                       Relation                            Phone

1._____________       __________________        _________________

2._____________      ___________________        ________________

3._____________      ____________________       ________________

4.____________       _____________________      _________________

Allergies:__________________________________________________

Food Sensitivities___________________________________________

Does your child have asthma? yes or no  

Does your child have an inhaler ? Yes or no       Does your child have an epi pen? yes or no

e mail address________________________________________

Photo release:

Permission for my child,____________________________to have their picture taken for publication on the church’s web site, school’s facebook page and the local paper

___Yes, I give my permission

___No, I do not give my permission

Signed________________________________Date___________________   

Please include a copy of your child’s inoculation record before school begins

          Please attach photo

tration form for Nursery School

                                   Trinity Lutheran Nursery School 

                                                  Registration

                                                                        2020-2021

Child’s Name___________________________        Date of application_____________

Nickname______________________________         Birth Date____________________

Address________________________________        Phone_______________________

             ________________________________         Email address____________________________

Mothers’ Name__________________________                    Work Number_________________

Occupation______________________________                    Cell Phone___________________

Father’s Name___________________________                    Work Number________________

Occupation______________________________                   Cell Phone___________________

List of siblings, name , school presently attending and ages:

________________________         __________  _________________________________

________________________         __________  ________________________________

________________________         __________  ________________________________

________________________         __________  ________________________________

________________________         __________ ________________________________

Religious affiliation___________________ Church Name___________

Nearest neighbor of relative in case of an emergency:

Name__________________    Phone____________

Address_________________________________________                

 Name __________________Phone__________

Address________________

Doctor_______________________         Phone_______________

Dentist_______________________         Phone_______________

In case of an emergency, my child may be taken to ________________________(hospital)

Food sensitivities____________________________Does your child have asthma?___________

Allergies___________________________________

Does your child have an inhaler? _____ or epi pen? ___________

Any important information you would like to share about your child such as habits, likes, dislikes, illnesses,___________________________________________________________________

I give my permission for the school to administer first aid to my child,_____________________________

Signed_____________________________.

I give my permission for ____________________________to participate in any class activity or trip during the school year thereby releasing the school from any liability.      Signed_____________________Date__________

Return the Registration form and Pick up form with the Registration fee

Please return a copy of your child’s inoculation schedule before classes begins in September                                                     

Please check:

Nursery Class ( 3 year old A.M. program) 9 to 11:30

2 day Monday and Wednesday class_________                            

2 day Tuesday and Thursday    class_________

  (the 2 day Nursery class offers an optional 3rd day, Friday )

  (if interested, please check here ___________)

3 day Tuesday, Wednesday, Thursday class_____(optional 4th day on Friday)______

5 day Nursery class______________

Pre-K (4 year old A.M. program)9 to 11:30                                  

5 day Monday thru Friday________

4 day Monday thru Thursday class________

3 day Tuesday, Wednesday Thursday class_____

Pre-K class. 8:45 to 1:45

5T day Monday thru Thursday 8:45 to 1:45

    Friday 8:45 to 11:30 _______

Fees:

Registration:                      Activity

5 day $ 40.00                     Pre-k classes      $22.00

4 day $ 40.00                     Nursery classes  $20.00

3 day $ 35.00

2 day $ 30.00

Arrival and Dismissal                                                                                              

A.M. classes 9 to 11:30

5 day pre-k  class 8:45 to 1:45 Monday thru Thursday ,

                                                8:45 to 11:30 Fridays

**EARLY MORNING ARRIVAL 8:00FREE*************

Tuition fees:

2 day program $190.00

3 day program $ 225.00

4 day program $255.00

5 day program $ 285.00                      (9 to 11:30)                

5 day transitional program $320.00 (8:45 to 1:45)…Friday (9 to 11:30)

******Lunch Bunch..11:30 to 1:30..fee is $10.**************

******LATE SHOW 1:30 to 3:00….fee is $10        3:00 to 5:00…the fee is $10.00

Payment is due the first school day of each month for 9 months.  The fee is $_______a month

Signature of Parent_______________________

Does your child receive services from DCIU or Early Intervention?______

If your child has an IEP, please give a copy to the teacher and one to the director

If you do not have a home church , would you like to have the Pastor visit you?  Yes or No

    2020-2021

    Trinity Lutheran Nursery School & Mothers’ Morning Out

Child’s Name_________________________________

Days and Room child is enrolled _______________________________________

Emergency Contact information:

In the order of notification (include parents)

Name                       Relation                              Cell number

1.___________         __________________        ______________

2.___________         ___________________      ______________

3.___________        ____________________     _______________

4.___________        ___________________-     ________________

People Permitted to pick up your child from school:

Name                       Relation                                 Cell Number

1._____________       __________________        _________________

2._____________      ___________________        ________________

3._____________      ____________________       ________________

4.____________       _____________________      _________________

Allergies:__________________________________________________

Food Sensitivities___________________________________________

Does your child have asthma? yes or no  

Does your child have an inhaler ? Yes or no       Does your child have an epi pen? yes or no

e mail address________________________________________

Photo release:

Permission for my child,____________________________to have their picture taken for publication on the church’s web site, school’s facebook page and the local paper

___Yes, I give my permission

___No, I do not give my permission

Signed________________________________Date___________________   

Please include a copy of your child’s inoculation record before school begins

Registration form for Nursery School

                                   Trinity Lutheran Nursery School 

                                                  Registration

                                                                        2020-2021

Child’s Name___________________________        Date of application_____________

Nickname______________________________         Birth Date____________________

Address________________________________        Phone_______________________

             ________________________________         Email address____________________________

Mothers’ Name__________________________                    Work Number_________________

Occupation______________________________                    Cell Phone___________________

Father’s Name___________________________                    Work Number________________

Occupation______________________________                   Cell Phone___________________

List of siblings, name , school presently attending and ages:

________________________         __________  _________________________________

________________________         __________  ________________________________

________________________         __________  ________________________________

________________________         __________  ________________________________

________________________         __________ ________________________________

Religious affiliation___________________ Church Name___________

Nearest neighbor of relative in case of an emergency:

Name__________________    Phone____________

Address_________________________________________                

 Name __________________Phone__________

Address________________

Doctor_______________________         Phone_______________

Dentist_______________________         Phone_______________

In case of an emergency, my child may be taken to ________________________(hospital)

Food sensitivities____________________________Does your child have asthma?___________

Allergies___________________________________

Does your child have an inhaler? _____ or epi pen? ___________

Any important information you would like to share about your child such as habits, likes, dislikes, illnesses,___________________________________________________________________

I give my permission for the school to administer first aid to my child,_____________________________

Signed_____________________________.

I give my permission for ____________________________to participate in any class activity or trip during the school year thereby releasing the school from any liability.      Signed_____________________Date__________

Return the Registration form and Pick up form with the Registration fee

Please return a copy of your child’s inoculation schedule before classes begins in September                                                     

Please check:

Nursery Class ( 3 year old A.M. program) 9 to 11:30

2 day Monday and Wednesday class_________                            

2 day Tuesday and Thursday    class_________

  (the 2 day Nursery class offers an optional 3rd day, Friday )

  (if interested, please check here ___________)

3 day Tuesday, Wednesday, Thursday class_____(optional 4th day on Friday)______

5 day Nursery class______________

Pre-K (4 year old A.M. program)9 to 11:30                                  

5 day Monday thru Friday________

4 day Monday thru Thursday class________

3 day Tuesday, Wednesday Thursday class_____

Pre-K class. 8:45 to 1:45

5T day Monday thru Thursday 8:45 to 1:45

    Friday 8:45 to 11:30 _______

Fees:

Registration:                      Activity

5 day $ 40.00                     Pre-k classes      $22.00

4 day $ 40.00                     Nursery classes  $20.00

3 day $ 35.00

2 day $ 30.00

Arrival and Dismissal                                                                                              

A.M. classes 9 to 11:30

5 day pre-k  class 8:45 to 1:45 Monday thru Thursday ,

                                                8:45 to 11:30 Fridays

**EARLY MORNING ARRIVAL 8:00FREE*************

Tuition fees:

2 day program $190.00

3 day program $ 225.00

4 day program $255.00

5 day program $ 285.00                      (9 to 11:30)                

5 day transitional program $320.00 (8:45 to 1:45)…Friday (9 to 11:30)

******Lunch Bunch..11:30 to 1:30..fee is $10.**************

******LATE SHOW 1:30 to 3:00….fee is $10        3:00 to 5:00…the fee is $10.00

Payment is due the first school day of each month for 9 months.  The fee is $_______a month

Signature of Parent_______________________

Does your child receive services from DCIU or Early Intervention?______

If your child has an IEP, please give a copy to the teacher and one to the director

If you do not have a home church , would you like to have the Pastor visit you?  Yes or No

    2020-2021

    Trinity Lutheran Nursery School & Mothers’ Morning Out

Child’s Name_________________________________

Days and Room child is enrolled _______________________________________

Emergency Contact information:

In the order of notification (include parents)

Name                       Relation                              Cell number

1.___________         __________________        ______________

2.___________         ___________________      ______________

3.___________        ____________________     _______________

4.___________        ___________________-     ________________

People Permitted to pick up your child from school:

Name                       Relation                                 Cell Number

1._____________       __________________        _________________

2._____________      ___________________        ________________

3._____________      ____________________       ________________

4.____________       _____________________      _________________

Allergies:__________________________________________________

Food Sensitivities___________________________________________

Does your child have asthma? yes or no  

Does your child have an inhaler ? Yes or no       Does your child have an epi pen? yes or no

e mail address________________________________________

Photo release:

Permission for my child,____________________________to have their picture taken for publication on the church’s web site, school’s facebook page and the local paper

___Yes, I give my permission

___No, I do not give my permission

Signed________________________________Date___________________   

Please include a copy of your child’s inoculation record before school begins

          Please attach photo