Registration Form | Hosanna Lutheran Childhood Center

1Select Program

2Child Information

3Registration Fee

Child Admissions Information
Registering Parent/Custodian's Address*
Street Address City State ZIP Code
Registering Parent/Custodian's Home Phone
Registering Parent/Custodian's Work Phone
Registering 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 State ZIP Code
Second Parent/Custodian's Home Phone
Second Parent/Custodian's Work Phone
Second Parent/Custodian's Cell Phone
Name 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 with a debit or credit card. After completion you will receive a follow-up email detailing your submission.
Registration Fee*
- Registration Fee $50.00
- Registration Fee + $120.00 Enhanced Educational Activity Fee
Registration Fee*
- Registration Fee $50.00
- Registration Fee + $120.00 Enhanced Educational Activity Fee
Total
$0.00
Parent's Signature (Typed)*
First Last
Name
This field is for validation purposes and should be left unchanged.

Hosanna Lutheran Childhood Center 2022-2023 Registration Form