Office Use:
Date Returned:_______

Check #:____________

Amount:____________

Initials:________

Lord of Love Preschool
2017-2018 Registration Form
Ages 3-5

Child’s Full Name____________________________ Preferred Name:________________

Childs Date of Birth__________________________________   Male____  Female ____

Childs Home Address________________________________  City_______ Zip______

Phone Number___________________ Email_________________________________

Mother’s Name_______________________  Fathers Name_______________________

Child Lives With _______________________________________________________

Class Options:  (Circle one))		Classes are $210.00 per month

AM Class M-F 9:00-11:30		PM Class M-F 12:30-3

**Classes fill based on a first come first serve basis, If your first choice is full, would you be interested in the other class session?  Yes  /  No

How did you hear about Lord of Love Preschool?_________________________________

Lord of Love Preschool welcomes all children regardless of religion, race, color, national or ethnic origin. Children must be at least 3 years of age and completely toilet trained at the start of school.

A Non-Refundable $75.00 registration fee is due at the time of registration.
The registration fee will hold your spot and cover the cost of supplies for the school year.
Please send registration payable to: Lord of Love, 10405 Fort St., Omaha, NE 68134.