Register a Child

Child's Name *

First

Last

Name to be used on Name Tags *

Address *

Zip Code *

Phone Number *

Birth Date *

Gender

Email *

Email

Confirm Email

Father's Name *

First

Last

Cell Number *

Occupation

Work Phone

Mother's Name *

First

Last

Cell Number *

Occupation

Work Phone

Child lives with: *

Both Parents
Mother
Father
Other

Please list any brothers: (Name & Age)

Please list any sisters: (Name & Age)

Church Affiliation

CLASS PREFERENCE: *

3 Years Old Monday, Wednesday & Friday Mornings
4 Years Old Monday, Wednesday & Friday Mornings
Pre-K Class Monday, Tuesday, Wednesday & Friday Mornings

Enrollment is on a “first-come, first-serve” basis. To ensure that your class is available for your child, please register early. Please mark your 1st and 2nd choice for which class you would like to enroll your child.

Name of First Emergency Contact *

First

Last

Phone Number *

Relationship to child *

Name of Second Emergency Contact *

First

Last

Phone Number *

Relationship to child *

Please list any allergies & their reactions (ex. milk allergy – stomach ache), special needs or disabilities of which we should be aware: *

Please list any previous school experience your child has had:

Has there been any home experience that might affect your child's behavior in school such as a death, frequent moves, divorce, recent births, etc.?

Please list 2 parents/guardians and 2 other individuals who have permission to pick up your child from school. *

Please list full Name and Relationship (Example: Jane Doe – Mom)

Are there any custodial issues which we need to be aware of?

If yes, please speak with the director.

I understand the rules for picking up students at Christ United Methodist Pre-School. *

Yes
No

The first time your child is picked up by a new person, we will check the Driver’s License in order to verify the identity. If the Adult is included in the list above, your child will be released to the Adult. If the Adult is not listed above, then your child will NOT be released to the Adult. If you know ahead of time that an Adult, who is not listed above, will be picking up your child, you MUST provide a written note to your child’s teacher. If this is a “last minute” change, you MUST call the office and speak to the Director personally. Any Adult not listed, will be asked to provide their Driver’s License to be copied, and sign a form which states that your child is being released to him/her, once we verify permission from the parents. Please read the extended policy in your child’s handbook which you will receive on Parent Night. For the safety of ALL students we will strictly follow this policy.

Please check off the appropriate boxes, then sign and date the form. *

I give Christ United Methodist Preschool permission to take photos or videos of my child. The photos and/or videos will NOT be released to the press without specific written consent. Photos will be used throughout the school on bulletin boards and featured in the end of year slide show. We try to place photos on our website as well; however student’s names will not be posted on the school’s website along with the photo.
I understand that in order for my child to attend Field Trips an adult must provide his/her transportation and remain in attendance with said child.
I deny permission to Christ U. M. Church to use a photo of my child involved in preschool activities on their web page. I understand that no child’s name or any other information regarding them will be given.

Please check all items you wish to be distributed on your child’s class list *

include our names (parents)
address
email address
phone number

Child's Name *

First

Last

Parent or Gaurdian Name *

First

Last

Date *

Call our Preschool Director, Laural Crawford at 814-838-8918 to inquire about any current openings.

Registration for the 2025-2026 school year is now open. To register fill out the form below, submit it and then send a check for the $60 registration fee (Non-Refundable) to Christ United Methodist Preschool.