Skip to content
Home
About Us
Our Mission
Staff
Programs
2’s Program
3′s Program
Pre-K 4′s Program
Pre-K 5’s Program
Summer Program
Presby Life
Special Events
Presby Parents
School Store
Enrollment
Forms
Referral Program
Gallery
Tour
Employment
Presby Insiders
Staff
Families
Student Enrollment
Home
•
Student Enrollment
Student Enrollment
admin
2023-06-27T16:37:20+00:00
Child's Name
(Required)
First
Last
Child's Age
(Required)
Date of Birth
(Required)
MM slash DD slash YYYY
Child's Gender
(Required)
Male
Female
Address
(Required)
Street Address
City
State / Province / Region
ZIP / Postal Code
Parent 1 Information
Name
(Required)
First
Last
Phone
(Required)
Email
(Required)
Business Address
(Required)
Street Address
City
State / Province / Region
Parent 2 Information
Name
(Required)
First
Last
Phone
(Required)
Email
(Required)
Business Address
(Required)
Street Address
City
State / Province / Region
Program of Interest
Please Select one
(Required)
2-Day 2s - T/Th, 9 am -12 pm
3-Day 2s - M/W/F 9 am -12 pm
3s - T/Th/F, 9 am -12 pm
3-Day Pre-K 4s - M/W/F, 9 am-12 pm Sept-Dec/9am - 1:30 pm Jan-May
4-Day Pre-K 4s - M/W/Th/F, 9 am -12 pm Sept-Dec/ 9 am - 1:30 pm Jan-May
4-Day Pre-K 5's MT/W/F, 9 am - 1:30 pm
5-Day Pre-K 5's M - F, 9 am - 1:30 pm
Where did you first learn of our Preschool and its programs?
(Required)
We’re a returning family
Word of Mouth (relative, friend)
Appeared in Google Search
Social Media (ie Facebook Page or Moms of Fairfield Post)
Community Resources (ie Fairfield Library Website or Fairfield Moms Website)
Community Event
Emergency Form
Child's Name
(Required)
First
Last
Person/s Responsible for Child?
(Required)
Parent 1 Name
(Required)
First
Phone Number
(Required)
Parent 2 Name
(Required)
First
Phone Number
(Required)
Emergency Contacts
The following persons are authorized by me to pick up my child from school if I am unable to do so AND may also be called in an emergency
if the parent/guardian cannot be reached.
(Please list at least 2 local names and numbers - not the child's parents).
Name and relationship to child. What does your child call them?
(Required)
Phone Number
(Required)
Name and relationship to child. What does your child call them?
(Required)
Phone Number
(Required)
Name and relationship to child. What does your child call them?
Phone Number
Name and relationship to child. What does your child call them?
Phone Number
Authorized Pickup Contacts
The following persons are authorized by me to pick up my child from school if I am unable to do so, but should not be called in an emergency. (Please list at least 2 local names and numbers - not the child's parents).
Name and relationship to child. What does your child call them?
(Required)
Phone Number
(Required)
Name and relationship to child. What does your child call them?
(Required)
Phone Number
(Required)
Name and relationship to child. What does your child call them?
(Required)
Phone Number
(Required)
IGNORE THIS SECTION. EMPTY CONTENT
Name and relationship to child. What does your child call them?
Phone Number
Name and relationship to child. What does your child call them?
Phone Number
Name and relationship to child. What does your child call them?
Phone Number
Does your child have allergies? If so, is an Epi-Pen required?
(Required)
Does your child have any general health concerns?
Pediatrician Name
(Required)
Pediatrician Phone Number
(Required)
Consent
I give permission to the Presbyterian Nursery School to make whatever emergency (e.g., first aid, disaster evacuation) measures as judged necessary for the care and protection of my child while under their direct supervision. In case of a medical emergency, I understand that my child will be transported to St. Vincent’s Medical Center by the local emergency resource (Police or Rescue Squad) if they deem it necessary. However, it is understood that the emergency resource will determine which medical facility/hospital to transport the child to depending on the nature of the emergency. It is understood that in some medical situations, the staff will need to contact the local emergency resource before the parent, the child’s physician and/or other adult acting on the parent’s behalf. The child will be transported at the expense of the parents/guardian or the parent’s/guardian’s Insurance Company.
IGNORE THIS SECTION. EMPTY CONTENT
IGNORE THIS SECTION. EMPTY CONTENT
IGNORE THIS SECTION. EMPTY CONTENT
IGNORE THIS SECTION. EMPTY CONTENT
IGNORE THIS SECTION. EMPTY CONTENT
IGNORE THIS SECTION. EMPTY CONTENT
IGNORE THIS SECTION. EMPTY CONTENT
IGNORE THIS SECTION. EMPTY CONTENT
IGNORE THIS SECTION. EMPTY CONTENT
IGNORE THIS SECTION. EMPTY CONTENT
Permission Form
1. We would like the following information to be included in the Presby Kids Directory:
Parent 1 - Cell Phone #
Parent 1 - Email address
Parent 2 - Cell Phone #
Parent 2 - Email address
Select All
This school directory has been prepared by PNS. It is intended for the sole use of Presby Kids parents. This directory is not to be used beyond the Presby Kids community. *Parents' name, child's name, and child's class will be automatically be included.
2. I/We grant permission for my child to use all the play equipment and participate in all activities while at Presbyterian Nursery School (PNS).
(Required)
Yes
3. I/We grant permission for my child to leave the building and participate in on-site field trips under the supervision of PNS staff.
(Required)
Yes
4. I/We grant permission for my child to be photographed or videotaped for usage in the school’s marketing and publicity which can include but not limited to website, promotional materials, internet and social media.
(Required)
Yes
No
5. I/We grant permission for the PNS or church staff to take whatever steps may be necessary to provide emergency medical treatment. These steps may include but are not limited to administer first aid, contact child’s parent/guardian or physician, call an ambulance if necessary, transport child to emergency hospital or walk-in if parent advises or is not reachable. Any expense incurred due to a medical emergency will be the responsibility of the child’s family.
(Required)
Yes
6. I/We grant permission for my child to be evaluated by members of the Presby Kids team.
(Required)
Yes
7. I/We grant permission for my child's teacher and the Director to contact my child's prior preschool and prior/current service providers.
(Required)
Yes
No
I acknowledge that I have read the parent handbook and agree to abide by the policies contained in it and that the techniques used to manage child behaviors in the facility have been discussed with me prior to enrollment.
(Required)
Yes
8. I/We grant permission for First Presbyterian Church of Fairfield to email me/us with information related to church events.
(Required)
Yes
No
Parent Agreement
I acknowledge that I have read the Attendance & Health portion of the parent handbook and agree to abide by the policies contained in it.
(Required)
Yes
I have read and reviewed the following material from the Presbyterian Nursery School: Tuition Agreement, Form Requirements, and Permission Form.
(Required)
Yes
I understand the need to have current contact information on file for Parents/Guardians, Emergency Contacts, and Authorized Pickup Contacts and agree to update the school as necessary.
(Required)
Yes
Standard Binding Tuition Agreement
I understand that I am responsible for the balance of the year’s tuition in the event of withdrawal. Extraordinary circumstances may be considered for the following reasons: the specific request from Presby Kids with just cause, or for verified medical conditions which preclude participation in the program.
(Required)
Yes
I understand that a $150 Enrollment Fee & one month’s tuition is due at enrollment and the second tuition installment is due by May 1st. The balance, or next payment, is due on September 1st, and semi-annual or installment payments are due on the FIRST of the appropriate month thereafter.
(Required)
Yes
Any bank fees incurred by the school will be passed to the parent/guardian responsible for the student.
(Required)
Yes
I accept the conditions above and register my child to the following Presby Kids Program
(Required)
2s Class (2 days)
2s Class (3-days)
3s (3-days)
Pre-k 4 (3-day)
Pre-k 4 (4-day)
Pre-K 5 (4-days)
Pre-K 5 (5-days)
Tuition Schedules
Please click here to review the tuition schedules.
Tuition Schedule Agreement
(Required)
Yes, I agree to the outlined tuition schedule.
I also agree to and take responsibility for the payment of the fees as stated on page two of this tuition agreement with payments scheduled as follows:
(Required)
Annually
Semiannually
9 Installments
Typing your name and date in the following field constitutes a binding digital signature
(Required)
Page load link
Go to Top
