FIRST UNITED METHODIST CHURCH MOULTRIE
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First United Methodist Church Pre-School Registration Application
Completing this form submits your information to our pre-school for registration only,
Registration will not be complete until payment is received, and you receive an email with your enrollment confirmation.
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Indicates required field
Child's Name
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First
Last
Childs Birthday
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Child's Age on September 1, 2023
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Class
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2 year old class | Monday & Wednesday
Waitlist: 2 year old class TTh
3 year old class
Advanced 3/4 year old class
Sex:
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Male
Female
Name they prefer to be called
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Physical Address
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Line 1
Line 2
City
State
Zip Code
Country
Mailing Address (if different)
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Line 1
Line 2
City
State
Zip Code
Country
Email
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Home Phone Number
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Emergency Contact Info- Name
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First
Last
Emergency Contact Info - Phone Number
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Emergency Contact Relation
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Mother's Name
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First
Last
Occupation
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Work Phone Number
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Cell Phone Number
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Father's Name
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First
Last
Occupation
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Work Phone Number
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Cell Phone Number
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Marriage Status
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Married
Divorced
Other
Child lives with:
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both parents
mother only
father only
grandparents
other
If other, please specify,
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Church Affiliation
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Physician
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Known Allergies
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Insurance Provider
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Policy #:
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Special Needs or Concerns
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Siblings Names & Ages:
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Please enroll my child in:
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2 year old 2 day/week Mon & Wed $100/month, $100 Reg Fee
2 year old 2 day/week Tues & Thurs $100/month, $100 Reg Fee
2 year old 4 day/ week $180/month, $180 Reg Fee
3 year old 4 day/week $180/month, $180 Reg Fee
Advanced 3/4 year old 4 day/week $180/month, $180 Reg Fee
Choose One:
**Three and Four Year Olds must be potty trained
The General Conference of The United Methodist Church, in April 1996, adopted a resolution aimed at reducing the risk of child sexual abuse in the church. Thus, in covenant with all United Methodist congregations, we adopted this policy for the prevention of child abuse in our church. There are cameras in all preschool rooms that protect the child and the teacher.
**Please note: The Registration Fee guarantees your child a place in our program and is non-refundable.
Once your form is submitted to our preschool, you must still pay your registration fee to hold your child's spot in our program.
Medical Release: If my child needs medical care while he/she is in your custody, by initialing below and electronically submitting my form, I authorize you to seek such medical care and to execute any documents required by a health care provider. I also understand that all attempts will be made to contact me if any injury results.
Electronic Signature accepting Medical Release. Please enter your full name below.
*
Date
*
Submit
Home
Contact & Address
Meet Our Staff
Worship Opportunities & Mid-Week Activities
First Time Visitors
Sunday School
Church Calendar
Music Ministry
Youth Activities
Seniors 2023
Children's Activities
SAFE SANCTUARIES
Preschool (J.A.M.)
Connection Groups
Online Giving
FUMC Missions
Church History
Worship Service videos
Job Opportunities
2023 Connect Camps