KKLC - Online Registration 2025-2026 (Step 1 of 3)

Kingdom Kids Learning Center

Preschool Registration

2025-2026 School Year

We are excited at the prospect of partnering with your family to meet your child's preschool needs. Please keep in mind that your child must be 3 or 4 years old by Sept. 1, 2025 to be eligible for the 2025-2026 school year.

Thanks for understanding that priority is given to registrations in the order in which they are received.

- Step 1 of 3: Complete the INFORMATION BELOW then click continue...

* YOUR NAME (Person filling out this form)

* YOUR PHONE

REGISTRATION INFORMATION:

- Registration Fee - A $35.00 non-refundable registration fee is required for each student being registered. It is required in order to complete the online registration process and will be payable upon submission of this form.. Registering with cash or check is not available online and must be done by submitting a printed registration form with your payment.

STUDENT INFORMATION

- Please complete the Student(s) Information Below.

* Preschool Class Choice (2025-2026)

* Child First Name

* Child Last Name

* Child Gender

* Child Birth Date

* Child Address

* Child City

* Child State/Province

* Child Zip/Postal Code

Child's Race / Ethnic Affiliation (Optional)

* Primary Language Spoken at Home:

* Child Lives With:

MEDICAL CONDITIONS:

- Please explain any illness or unusual medical condition that might prevent your child from participating in activities or conditions which the staff should be aware of.

Child Allergy/child notes

* Doctor's Name

* Doctor's Phone #

EMERGENCY CONTACTS:

- (Other than parent / guardian if possible) In Case of Emergency please Notify these Secondary Contact(s).

* Child Emergency Contact #1 NAME

* Child Emergency Contact #1: PHONE

* Child (#1) - Relationship to Child:

* Child (#1) - AUTHORIZED to Pick Up Child :

* Child Emergency Contact #2: NAME

* Child Emergency Contact #2: PHONE

* Child (#2) - Relationship to Child

* Child (#2) - AUTHORIZED to Pick Up Child:

ADDITIONAL INFORMATION:

- Please provide the following additional information.

* 1.) Please share any important information regarding your child which would lead to a better understanding of him/her (i.e., fears, interests, bathroom needs, behavior, etc.):

* 2.) What do you hope Kingdom Kids Learning Center will accomplish with your child?

* 3.) How did you hear about our preschool? (Friend, Social Media, Faith Alive Church, LBLC, Other)

REGISTRATION INFORMATION:

STUDENT INFORMATION

MEDICAL CONDITIONS:

EMERGENCY CONTACTS:

ADDITIONAL INFORMATION:

STEP 1 of 3 (please continue)

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