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:

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

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:

Class Time:
Note for 4/5 Year Old Program - Class time on Fridays will end 45 minutes earlier.

Signature:

We Would Love to Hear From You!

Hours

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:

Class Time:*Note for 4/5 Year Old Program* - Class time on Fridays will end 45 minutes earlier.

Signature:

We Would Love to Hear From You!

Hours

Telephone

Email

United Preschool Center
Registration
2022 - 2023

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

Class Time:
Note for 4/5 Year Old Program - Class time on Fridays will end 45 minutes earlier.