Registration for KOK – First Presbyterian Church

Student's Name

Goes By

Age

Birthdate

Boy/Girl

Other Schools Attended

Age of Child by September 1

Parental Insight: Please tell us anything you think is especially important about your child that would help us know him/her better:

Family Information: Father's Name

Mother's Name

Address

City

State

Zip Code

Home Phone

Cell Phone

Father's Occupation

Father's Employer

Work Phone

Mother's Occupation

Mother's Employer

Work Phone

If Child is not living with both parents, please indicate with whom the child is living:

Other Siblings:

Church Affiliations: Name of Church

Pastor/Priest

Phone Number

If emergency medical treatment is necessary and I cannot be reached, I hereby give permission to Kids of the Kingdom Preschool to secure proper medical treatment. This may include, but not limited to, hospitalization, surgery, ordering injection, anesthesia for the child listed:

List allergies and special medical information that we should know:

List any medications taken on a regular (daily) basis by your child:

Name of Physician

Phone

Parent Signature

Initials

date

Emergency Information: Please list local persons to contact in an emergency if parents cannot be reached:

Field Trip Permission Slip: I hereby give permission for_________ to participate in any off campus field trips during the school year. I understand that school transportation or walking may be used.

Release Form: When your child is brought to school, he/she must be left in the presence of a staff person. You must also make a staff person aware of your child's departure. Please list persons below, in addition to parents, who are approved to pick up your child.

Parental signature and initials (Please notify the school immediately of changes or modifications to any and all information stated.)

I recognize that the Kids of the Kingdom Preschool works as an extension of me, the parent, and I pledge to my prayerful support to the school and its staff. I understand that the school goals are to provide excellence in academics and to nurture our children in the highest principles of Christian Education. I understand that the operating expenses of a school like Kids of the Kingdom are fixed, and a loss is realized if any vacancy occurs during the school year. In support of the school's obligation to its staff, I agree to enroll my child for the entire school year. (Exception: Moving) I understand that no reductions can be made for vacations, holidays, or for any other absences regardless of cause. I understand that tuition will be pro-rated in the event my child is withdrawn from the school, it is agreed that all sums of money paid to the shcool shall be retained by the school. If my child is withdrawn after the first of the month, I agree to pay full tuition for that month. I understand that tuition is due and payable on the first of each month, unless a payment plan is approved by the school. I also understand that registration fees are non-refundable. I hereby release Kids of the Kingdom Preschool of any responsibility for any accident or injury that might occur while on school premises or en route to and from school while involved in any school activity. If concerns or disagreements arise over issues or accidents related to the welfare of our children, we will go to the individual to seek a mutually satisfactory remedy in the bonds of Christian love.