P&T Form (New)

Parent & Toddler Program Registration

Welcome! We’re so glad you’re interested in our Parent & Toddler Program. This six-week session is a joyful first step into preschool for children ages 21–33 months and their grown-ups. Please complete this form to reserve your spot. Once submitted, you’ll receive a confirmation email with next steps.

SESSION DETAILS

Tuition: $450 for six weeks
Registration & Payment: Please submit the registration form below and send payment via Zelle to [email protected]
Dates: September 30 – November 4, 2025 (Six-week program with the option to continue with future sessions)
Day/Time: Tuesdays, 4:00–5:15 PM

SECTION 1: CHILD'S INFORMATION

* Indicates required field

Name *

First

Last

Preferred Name *

Date of Birth *

Allergies *

SECTION 2: PARENT/GUARDIAN INFORMATION

Parent/Guardian Name *

First

Last

Relationship to Child *

Email *

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Secondary Parent/Guardian *

First

Last

Relationship to Child *

Email *

Phone Number *

Address (only if different) *

Line 1

Line 2

City

State

Zip Code

Country

SECTION 3: EMERGENCY CONTACT

Name *

First

Last

Relationship to Child *

Phone Number *

Submit