Test registration form

Test registration form

  • There will be a non refundable $200 fee for registration which must be paid upon form submission.
  • MM slash DD slash YYYY
  • PARENT/GUARDIAN INFORMATION

  • What days/hours are you interested in?

  • Any changes will be made upon the school's discretion. Please note that there will be a fee if there will be any changes made to the schedule selected above. An additional $75 will be charged to anyone who changes their child's schedule before the first week of school. A $150 fee will be charged after the first week of school.
  • We cannot guarantee your preferred days. Please keep in mind that we can best provide for those who are flexible.
  • PICKUP

  • I have reviewed the guidelines and I hereby register my child for the 2021-2022 school year. I also understand that once my child is accepted and contracts are signed, there are no refunds under any circumstances.
  • MM slash DD slash YYYY
  • CHILD'S INFORMATION

  • FAMILY INFORMATION

  • EMERGENCY CONTACTS

  • Please indicate the names and telephone numbers where another authorized person(s)can be contacted in case of emergency:
  • CHILD'S DOCTOR

  • EMERGENCY CARE

  • In case of emergency, I authorize the staff to provide any medical care or first aid deemed necessary for my child. In case of an emergency in which I cannot be reached, the physician listed above and the local hospital are hereby authorized to provide any emergency care deemed necessary for my child. In case of emergency, I hereby authorize the transfer of my child's records to the local hospital. I hereby agree to the above and give my permission to care for my child in case of emergency, including medical care or first aid; transfer of care to my child's physician or local hospital and health records transfer.
  • MM slash DD slash YYYY
  • Registration fee is $200 non refundable deposit. To complete registration please zelle admissions@chaitotspreschool.com