Hope Lutheran Nursery School - Registration Form for 2024-2025

Thank you for your interest in registering your child in our program!

Select the class you wish to enroll your child in:
3 year old class on Tues/Thurs from 9 AM - 11:30 AM, $130 per month
4 year old class on Mon/Wed/Fri from 9 AM - 11:30 AM, $145 per month
* Child's first & last name: 
* Child's birthdate: 
* Child's home address: 
* Parent/Guardian child lives with: 
  
* Mother/Guardian: 
* cell phone: 
email address: 
address if different from child's: 
place of employment: 
work phone: 
* Father/Guardian: 
* cell phone: 
email address: 
address if different from child's: 
place of employment: 
work phone: 
* Primary phone number: 
* Can receive texts at this number:  Yes No
* Preferred email for school communication:  

Pick Up List: The following people have permission to pick my child up from Nursery School:

* Name: 
* Phone number: 
* Relationship: 
Name: 
Phone number: 
Relationship: 
Name: 
Phone number: 
Relationship: 
Name: 
Phone number: 
Relationship: 
Name: 
Phone number: 
Relationship: 
Name: 
Phone number: 
Relationship: 
Additionally, please list anyone who may NOT pick up your child. (If there are any custody arrangements, please provide documentation.):

Consent to Release Video, Digital, or Photographic Images
I hereby give my consent to Hope Lutheran Nursery School to use video, digital, or photographic images of my child in printed or web-based publications or media during the course of the school year. I also understand that I am under no obligation to provide this consent. (Please note, we do not publish any child's name with the photos.)
Yes  No

Field Trip Waiver
I agree and hereby release and discharge any Nursery School Staff or other person engaged in any field trip that my child attends from all claims, present and future, known and unknown, in any manner arising out of said activity. I understand and agree that this release shall hold any staff member or other person engaged in the field trip harmless from any and all liability relating to my child for any and all personal injury or illness that may be suffered by my child and further, I agree to hold them harmless from any loss of property by my child that may occur during a field trip with Hope Lutheran Nursery School.

Yes, I agree.  No I do not consent and understand that my child will NOT be allowed to participate in field trips without this consent.

Tuition Requirements
The monthly tuition for the 2024-2025 school year is $130 for 3 year olds and $145 for 4 year olds. Tuition is paid one month in advance and is due on the first school day of each month. September's tuition is due by May 1, 2024 to secure your child's spot in our program for the upcoming school year. October's tuition will be due by the first day of school. If tuition is not received by the 10th day of the month, a $10 late fee will be applied. If the tuition and the late fee are not received by the last school day in the month, the child may not attend until arrangements are made for payment. Tuition may be paid in cash or with a check made out to Hope Lutheran Nursery School. In the event of a returned check, the parent will be notified and expected to pay any fees. If two tuition checks are returned from the bank within one school year, all subsequent payments must be made in cash.
 I have read and understand the tuition requirements.

I confirm that the information I have provided is accurate and that it is my intention to enroll my child in Hope Lutheran Nursery School for the 2024-2025 school year.

Parent / Guardian Signature
Type your name

Draw your signature

* To complete the registration process, a non-refundable registration fee of $50 must be dropped off at Hope Lutheran Church. The Student Questionnaire can also be dropped off at this time. The church office is open between the hours of 8:30 AM and 3 PM on Monday through Friday. If you are stopping by between 12 PM - 1 PM, please call ahead to ensure the secretary will be in the office during this time. Additionally, the first month's tuition is due by May 1, 2024 and the Medical Form needs to be completed prior to the start of the school year.  *

We are looking forward to sharing this school year with your child. Thank you for giving us the opportunity to do so!