Registration Page

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

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

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 *

Select Program:

3/4 Year Old Class Time Options:
(First Year Preschoolers!)

Please Choose One: *

3/4 Year Old Program (T/TH) AM (9:30 a.m. start time)

4/5 Year Old Class Time Options:
(Second Year Preschoolers!)

Please Choose One: *

4/5 Year Old Program (M/W/F) PM (9:30 a.m. start time)

Optional Add on Classes:

Please Choose Optional Add On Classes: *

Yes, Add my student into the acrobatics class that follows the academic class time on Mondays (4/5 Yr Olds) or Tuesdays (3/4 Yr Olds). * This class is 45 minutes. Yes, Add my student into the creative movement dance class that follows the academic class time on Wednesdays (4/5 Yr Olds) or Thursdays (3/4 Yr Olds). * This class is 45 minutes. I am not interested in either.

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

United Preschool Center
Registration
2022 - 2023

Registration Form:

Primary Account Holder Information:

Secondary Account Holder Information:

Emergency Contact Information:
(Please list an emergency contact who is not a parent of the child)

Child's Information:

Select Program:

3/4 Year Old Class Time Options:
(First Year Preschoolers!)

4/5 Year Old Class Time Options:
(Second Year Preschoolers!)

Optional Add on Classes:

Signature:

We Would Love to Hear From You!

Address

Telephone

Email

United Preschool Center ​Registration2022 - 2023

Registration Form:

Primary Account Holder Information:

Secondary Account Holder Information:

Emergency Contact Information:(Please list an emergency contact who is not a parent of the child)

Child's Information:

Select Program:

3/4 Year Old Class Time Options:(First Year Preschoolers!)

4/5 Year Old Class Time Options:​(Second Year Preschoolers!)

Optional Add on Classes:

Signature:

We Would Love to Hear From You!

Address

Telephone

Email

United Preschool Center
Registration
2022 - 2023

Emergency Contact Information:
(Please list an emergency contact who is not a parent of the child)

3/4 Year Old Class Time Options:
(First Year Preschoolers!)

4/5 Year Old Class Time Options:
(Second Year Preschoolers!)