'Bright Beginnings Preschool' Registration Form
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1
22016-2017
‘Bright Beginnings Preschool’ Registration Form
Date:
Membership is required
Name of Child: (Last)
(First)
Child’s age as of 10/01/16
Male
Female
Date of Birth:
/
/
Sex:
Address:
City:
Zip Code:
Home Phone #: (
)
Mother’s Name:
Cell phone #:
Mother’s Business Address:
Mother’s Business Phone #: (
)
E-Mail Address:
Father’s Name:
Cell phone #:
Father’s Business Address:
Father’s Business Phone #: (
)
E-Mail Address:
Name and ages of Siblings:
I have read, understand and agree to all of the information as stated in the preschool brochure.
I hereby give permission for the JCC of Middlesex County to photograph or video my child(ren) and to use these pictures for
brochure or promotional purposes.
The JCC and Bright Beginnings Preschool are not responsible for clothing or personal property lost on its premises or while on
school related trips.
I hereby give permission for my child to participate in JCC preschool programs and activities, including trips away from the JCC
of Middlesex County.
The JCC does not assume responsibility for injury. In the event that I, or my physician cannot be contacted in an emergency, I
hereby grant permission to contact the nearest medical facility or physician to give emergency treatment at no cost to the JCC.
th
I understand that any changes to my child’s day must be done by the 10
of the prior month in order for the changes to take effect.
First month’s tuition, June’s tuition plus a registration fee are due upon registration. You will be billed 8 equal installments,
st
payable on or before the 1
of every month, October through May.
All monies are non-refundable and non-transferable.
__________________________________________________________
_____________________
Signature of Parent or Guardian
Date
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