Life Family Preschool Application

Life Family Preschool (formerly New Brighton Christian Assembly Preschool) admits students of any race, color, national and ethnic origin to all the rights, priviledges, programs and activities generally accorded or made available to students at school. It does not discriminate on the basis of race, color, national or ethnic origin in administration of its educational policies, admission policies and all school-administered programs.

If you need more information regarding our Preschool, please get in touch with Angela Dailey (our Preschool Director) by calling 724.846.8820 or email her at preschool@mylifefamily.com

*Please add preschool@mylifefamily.com to your email contacts so that emails from the Preschool are not sent to your Junk/Spam Folder.

Tell us about your child

Name

Nickname

Birthdate

Gender

Home Phone

Address

What school will your child be attending after graduation from Preschool? (School District or Home School)

Tell us about your family

Father's Name

Father's Cell Phone

Father's Employer

Employer Phone

Mother's Name

Mother's Cell Phone

Mother's Employer

Employer Phone

Parent's Marital Status

Parent's Email

This address will receive a confirmation email

In case of emergency

Emergency Contact (This person will be contacted if parents cannot be reached)

Relationship to child

Phone

Address

Tell us about your child's health information

Are your child's immunizations up to date?

Please list ANY allergies

Please list any medical conditions noted

Please list any special academic conditions noted

Please share with us any information that will help us to better understand your child. For example, habits, temperaments, any recent additions or changes to your family.

How did you hear about Life Family Church Preschool?

By typing my full name in this box, I am saying that all information included in this application is true and accurate and that I intend to enroll my child in the Life Family Church Preschool.

Preschool Class and Information

4 & 5-year-old class
Monday-Tuesday-Wednesday
9am- 12pm
$126 per month

Extended 4 & 5-year-old class
Monday-Tuesday-Wednesday
9am- 2pm
$210 per month

3 year old class
Thursday-Friday
9am- 12pm
$95 per month

I am enrolling my child in the

Extended 4 & 5 year old class 4 & 5 year old class 3 year old class

A $50 non-refundable registration fee is due upon submitting this application form.

Payment $50

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Life Family Preschool Application

Description

Please Fix the Following