Registration Form

KIDS UNDER CONSTRUCTION KIDS UNDER CONSTRUCTION
REGISTRATION FORM

Select one: *

Child's Name:
Birthday:
 /  / 
Address:
City:
Zip:
Parent's names:
List food allergies, if any:
Home Phone:
-
Work Phone:
-
Cell Phone:
-
E-mail address:




Program choices; please indicate 1st and 2nd choice:

Registration Fee:

2 1/2 year olds:

1 day Two - Friday
2 day Two - T/TH
2 day Two - M/W

3 year olds:

2 day Three - T/TH
3 day Three - T/TH/F
3 day Three - M/W/F

4 year olds:

3 day Four - M/W/F
4 day Four - M/TH
Pre-K - 5 Day - Must be 5 by 3/1/2016

* KUC Preschool offers a 10% discount on a second child


I understand that the registration fee is non-refundable once the child is accepted into the program and once enrolled that I am to be financially responsible for the child:


Parent full name