Hosanna Lutheran Childhood Center 2023-2024 Registration Form 1Select Program2Child Information3Registration Fee Registering Parent/Custodian's Name* First Last Registering Parent/Custodian's Email* Enter Email Confirm Email Registration Fee: $100.00 The registration fee is for both new and returning students. This fee is NON REFUNDABLE, and must be paid before your child’s registration will be processed and a spot in a class is held for them. NOTE: $50.00 of this fee will be credited toward tuition in the fall. Enhanced Educational Activity Fee: $120.00 This one-time fee is for both new and returning students.Child's Name* First Last Gender* Female Male Date of Birth* Month Day Year Age* I'm registering my child for* Preschool 5 Day Program $355.00 per month Preschool 3 Day Proram $210.00 per month - Class not available Preschool 2 Day Program $180.00 per month Pre-Kindergarten 5 Day Program $510.00 per month Pre-Kindergarten 3 Day Program $310.00 per month Pre-Kindergarten 2 Day Program $250.00 per month Preschool 5 Day, 3 Day or 2 Day Program3 & 4 year olds - Please indicate preferred choice.Preference - 5 Day Students* AM PM Preference - Monday/Wednesday/Friday* AM PM Preference - Tuesday & Thursday* AM PM Child Admissions InformationRegistering Parent/Custodian's Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Registering Parent/Custodian's Home PhoneRegistering Parent/Custodian's Work PhoneRegistering Parent/Custodian's Cell Phone*Second Parent/Custodian's Name First Last Second Parent/Custodian's Email Enter Email Confirm Email Address (if different) Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Second Parent/Custodian's Home PhoneSecond Parent/Custodian's Work PhoneSecond Parent/Custodian's Cell PhoneName your child is called at home: Name you wish your child to learn to recognize in print and writing: Child Lives With...include names and ages of siblings, as well as name and relationship of all adults in the household(s).Have any of your other children attended HLCC? If so, who and when? Has your child attended any structured activities? Has your child attended any other preschool? Did a current student refer you to HLCC? If so, who? What are your goals for your child this school year?*Are there any family or custody issues that would affect your child attending HLCC? In the case of a divorce or separation, the Center cannot deny a parent access to a child unless legal documentation has been provided to the Center.* HLCC will strive to enroll your child(ren) in your preferred class, but cannot guarantee such placement. If transportation is an issue and you need to be placed with specific families, please note that preference on the bottom of this form. Please review the parent handbook for policy on tuition payments, late pickups, and withdrawals. The current handbook is available at the following link: https://hlccpreschool.org/family-handbook/ ** All Children must be at least three years of age and fully potty trained to attend HLCC.After submitting the form you will be directed to pay the registration fee via PayPal. A PayPal account is not required. You may pay as a guest with a debit or credit card. After completion you will receive a follow-up email detailing your submission. If you do not pay the Enhanced Educational Activity Fee at registration, you will receive an invoice for this fee when your registration is processed. Registration Fee* Registration Fee $100.00 Registration Fee + Enhanced Educational Activity Fee $120.00 Total $0.00 Parent's Signature (Typed)* First Last EmailThis field is for validation purposes and should be left unchanged.
