Preschool Registration 2018-2019

Child's Name *
Child's Name
Date of Birth *
Date of Birth
Baptized *
Legal Guardians
Guardian's Name *
Guardian's Name
Cell/Home Phone *
Cell/Home Phone
Work Phone
Work Phone
Other Guardian's Name
Other Guardian's Name
Home Phone
Home Phone
Work Phone
Work Phone
Other Children
Baptized
Baptized
If applicable, please include other children, their age, grade level, school, and whether they are baptized.
Sessions
3K Program
4K Program
Full-Day Program

Non-refundable Registration Fee $70.00. After you submit the form above, you can mail the registration fee to our church office at 1530 S. Main St., Lake Mills, WI 53551.