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UNITED PRESCHOOL
Home
All About Us
Class Options
Register
For Parents
Contact Us
United Preschool Center
Registration
2022 - 2023
Please read through the Terms and Conditions Here:
Terms and Conditions
Registration Form:
Primary Account Holder Information:
*
Indicates required field
Primary Account Holder Name
*
First
Last
[object Object]
Primary Account Holder Email
*
Primary Account Holder Phone Number
*
Primary Account Holder Address
*
Line 1
Line 2
City
State
Zip Code
Country
I have read and agree to United Preschool Center's Terms and Conditions
*
Yes
Secondary Account Holder Information:
Secondary Account Holder Name
*
First
Last
[object Object]
Secondary Account Holder Email
*
Secondary Account Holder Phone Number
*
Secondary Account Holder Address
*
Line 1
Line 2
City
State
Zip Code
Country
Emergency Contact Information:
(Please list an emergency contact who is not a parent of the child)
Emergency Contact Name
*
First
Last
Emergency Contact Phone Number
*
Emergency Contact Relation to Child
*
Child's Information:
Child's Name
*
First
Last
Child's Date of Birth
*
Child Is
*
Male
Female
Medical Conditions / Dietary Restrictions
*
Please put "none" if you are not aware of any medical conditions or dietary restrictions.
Select Program:
Program
*
3/4 Year Old Program (T/TH) - Child must be 3 by 9/1/2022
4/5 Year Old Program (M/W/F) - Child must be 4 by 9/1/2022
Class Time:
*Note for 4/5 Year Old Program* - Class time on Fridays will end 45 minutes earlier.
Class Time
*
AM (9:30 - 12:30)
PM (12:15 - 3:15)
Signature:
By typing your name below, you agree that the above information is correct and agree to United Preschool Center's Terms and Conditions
*
Submit
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