Nursery School Registration 2025-2026 - The Lutheran Church of the Holy Spirit

Date

Holy Spirit Member?

Holy Spirit Congregation Member

Enrolled?

Child/Sibling Previously Enrolled
New Enrollment

Select Your Class(es) by clicking on your choice(s).

(Meets 9:00-11:45/12:30-3:00)

First School Experience

Tadpoles (Age 3 by Dec. 31, 2025) - 2 Days (Tues/Thurs AM) - $175.00+fees/month
Pollywogs (Age 3 by Dec. 31, 2025) - 3 Days (Mon/Wed/Fri AM) - $215.00+fees/month

.

Cubs... Getting Ready for Kindergarten

Panda Bears (Age 4 by Dec. 31, 2025) - 4 Days (Mon/Tues/Wed/Thurs AM) - $245.00+fees/month
Brown Bears (Age 4 by Dec. 31, 2025) - 3 Days (Mon/Tues/Thurs PM) - $215.00+fees/month
Polar Bears (Age 5 by March 1, 2026) - 4 Days (Mon/Tues/Wed/Thurs AM) - $245.00+fees/month

Other Programs For Play and Enrichment (A minimum class size is required to offer some classes)

Playful Penguins for ages 3-5 years - 1 or 2 days (Tues and/or Wed 11:45-2:15PM) - $25.00/day
Busy Beavers for ages 4-5 years - 1d (Fri 9:00-11:45AM) - $25.00/day

Your Child's Profile

Name *

First

Last

My child preferrs to be called: *

Date of Birth *

Gender *

Male
Female

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Primary Email

(Will be used for nursery school communication)

Primary Contact Number During School Hours *

Your Child's Family

Is English the primary language spoken at home?

Yes
No

If no, list primary language.

Child Lives With

If Other, Describe

If Parents Are Divorced, Separated, Single, List Any Special Arrangements

Primary Parental Contact *

First

Last

Occupation

Contact Cell Phone *

Email *

Address (If different from Child's)

Address Line 1

Address Line 2

City

State

Zip Code

Secondary Parental Contact

First

Last

Secondary Contact Occupation

Secondary Contact Cell Phone

Secondary Contact Email

Secondary Contact Home Address (if different from child's)

Address Line 1

Address Line 2

City

State

Zip Code

Other Members of Household

Name

Age

Relationship

Name

Age

Relationship

Name

Age

Relationship

Name

Age

Relationship

Child Information

My child enjoys

My child's relilgious group affiliation

Additional information I'd like to share about my child

All information is confidential and will only be shared with your child's teacher and the school director.

Health Information

Medical Conditions:

Allergies

Other Medical Conditions

Medications

Current in immunizations? *

Yes
No

(If child is not current, a waiver form will need to be completed.)

Has your child ever received learning support prior to preschool? (example: speech, physical/occupational therapy)

Yes
No

If yes, please describe and share current I.E.P.

Additional Information

To complete the registration process, the non-refundable fee ($75.00) must accompany this form. One registration fee is required per child. Checks are made payable to Holy Spirit Christian Nursery School. The registration fee holds a spot in a class until June 15th, when the first tuition payment is due. Tuition is a yearly fee and divided into nine payments. The first tuition installment is due on June 15th. This payment will reserve your child's spot in the class. No initial tuition payments are refunded after July 1st. A $25 materials fee is to be paid along with the first tuition payment.

I give my permission to share our name, address, phone number and email address with other members of the nursery school community for use in the Nursery School Directory *

Yes
No

How did you hear about Holy Spirit Christian Nursery School?

Signature of parent or guardian

For Official Use Only

Registration Fee paid by:

Cash
Check
Online payment

Check #