Friendship Garden PreSchool Registration

APPLICATION FOR ENROLLMENT 2025-2026

* Child's Name

* Gender

* Date of Birth

* Address

* Town, Zip

* Home Phone

* Elementary School and District

Mother's First Name

Mother's Last Name

Cell Phone #

Occupation

Business Phone #

Father's First Name

Father's Last Name

Cell Phone #

Occupation

Business Phone #

* Primary Parent Email

* How did you hear about our preschool?

Please list the first name, gender and date of birth of other children in the family.

* Family Physician

* Phone Number

* Address

In case of emergency (if parents cannot be reached) contact:

* Name

* Phone Number

* Address

* Relationship to child

* Is this person authorized to pick up your child from preschool?

YesNo

Is your child receiving special services from another group? If yes, what type and from whom (eg. speech, OT, counseling}

Does your child have any medical conditions? If so, please list.

Does your child have any allergies? If so, please list.

Is there any additional information we should know that might help us in working with your child?

**A $100 registration free and $50 activity fee MUST accompany this application. We require one registration fee per family. This is a non-refundable fee paid by cash or check made payable to the Merrick Jewish Centre. All enrollments are based on a first-come, first-serve basis and we must receive BOTH the application and registration fee to secure placement.

**Medical forms (OCFS Form 4433) indicating most current immunizations and proof that they are free from contagious and communicable diseases signed and stamped by your doctor's office must be submitted for each child BEFORE they can begin. (Click here to access the form).

**Tuition is due on the FIRST CLASS SESSION of each month.

**A 10% sibling tuition discount is available when enrolling more than one child in a school year.

**Permission is hereby granted in case of emergency, when neither parents, nor family physician can be reached, to have my child attended by a physician selected by the school.

* **Please indicate your permission to place your contact information on a class list.

YesNo

* **I have read this application and agree to the terms.

**I have read this application and agree to the terms.

Program Selection (please check one):

APPLICATION FOR ENROLLMENT 2025-2026

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