4 Year Old Registration Wednesday/Friday 12:00-2:30

Child’s Name *

Gender *

Male
Female

Child's Birthdate *

Age your child will be on Sept 1st *

Address *

Parent or Guardian Name *

Phone Number *

Email *

Preferred Method of Contact *

Call
Text
Email

Emergency Contact (Other than parent) *

Phone Number - Emergency Contact *

Medical conditions or known allergies *

Tell me about your child

Picture Upload

Click or drag a file to this area to upload.

Wallet or 4x6 size picture of your child

Please share with me any expectations you have from preschool

I hereby certify that my child is in normal health and capable of participation in preschool activities. I understand that my child will be participating in activities at preschool and that the preschool and preschool teacher will not be liable for any physical harm my child should incur from this activity. I also understand that I will not hold the preschool or preschool teacher responsible for injury including the transportation of my child to and from preschool and preschool activities. *

I accept these terms

I hereby give Telena Hall permission to seek medical treatment for my child if necessary (you will be notified first). I understand that I will be responsible for all costs associated with the treatment of my child.

I accept these terms

Doctor’s Name

Doctor’s Phone Number

CONSENT AND RELEASE: I hereby give my consent for the above-named child ("Student") to attend Little Learners Preschool (“LLP”) located at 4893 Hiram Ave, Chubbuck, ID 83202, for the 2026-2027 school year. While at LLP the student will engage in creative and educational activities with other students who are between the ages of three to five years of age, who can oft times have accidents that can result in minor injuries. While LLP has taken all necessary measures to provide appropriate supervision and a safe learning environment, unintentional accidents or injuries still may occur. I hereby release any and all claims against LLP or its owners or employees for personal injuries that the Student may suffer while attending LLP and interacting with other students. I also grant permission for photographs and videos to be taken of the Student to be used for the promotion of LLP on its website, Facebook and Instagram pages. *

I accept these terms

BEHAVIOR POLICY: At preschool age, children are still learning many social and personal skills and I will be helping them with this. However, I do expect the children to treat me and others with respect and kindness. If there is an occasion where a child is misbehaving or acting inappropriately and will not respond to reason, I will ask him/her to sit in our "calming area” for one minute or until behavior has calmed and child is able to control him/herself. If the child continues unacceptable behavior after three “rests”, he/she will not be able to join our activities for the rest of that class period and a parent may be contacted. Please prepare your preschooler to exhibit good behavior during our class time as this will help all who are attending to have a good experience and get the most out of our activities and group learning. I reserve the right to dismiss any child whose behavior continues to be a hindrance to our classroom, learning, and the well-being of others - indefinitely and without refund. *

I accept these terms

SICK POLICY: Strive to have your student at preschool each day, but please observe his/her health each time and make an exception when he/she is sick. Please keep your child at home in the case of: Fever of 100 degrees F, Diarrhea (more than one abnormally loose stool per day), Vomiting, Nausea, Severe cough, Unusual yellow color to skin or eyes, Skin or eye lesions or rashes that are severe, weeping, or pus-filled, Stiff neck and headache with one or more of the symptoms listed above, Difficulty breathing or wheezing, Complaints of severe pain, Lice. *

I accept these terms

TUITION POLICY: Tuition is due on or before the 5th of each month. After that, a $10 late fee will be assessed (unless prior arrangements have been made with me). If your account becomes one month behind, your child will not be allowed to come to class until tuition is caught up to the current month. Tuition is the same each month, even when there is varying number of classes from month to month. The days in class average out over the year and my lessons are planned for the entire year to meet our goals and finish our curriculum accordingly. Other charges may be incurred if you are not prompt in picking up your child after class. For every 15 minutes late, I will a charge $5 fee. If you need to leave your child longer, please visit with me to make arrangements. *

I accept these terms

Captcha *

=