Register

Mid-Year Enrollment the School Year 2025-2026
Preschool Pioneers
Pull-ups are allowed for this class only. Child must turn 3 years old between September 1 and December 31.
Choose the selection that applies*
Email preschooldirector@pplc.org to be added to the wait list if this class is FULL.
- No Preschool Pioneer to register
- FULL

Child's Enrollment Information
Enrollment*
- Currently enrolled or have a sibling currently enrolled
- Previously enrolled in our program
- New Enrollment to our program
How did you hear about us?*
- Friend
- Social Media Post
- Banner on the church
- Google Search
Child's Name*
First Last
Preferred name to learn to write
Sex*
- Male
- Female
Birthday*
MM slash DD slash YYYY
Address*
Address must match payment billing address

Street Address City State ZIP Code

Parent #1 Information
Please list the parent you want us to communicate the most with as Parent #1
Parent #1 Name*
First Last
Parent #1 Relationship to child*
Parent #1 Phone Number*
Parent #1 Email*
Parent #1 Address (if different than child's)
Street Address City State / Province / Region ZIP / Postal Code Country
Parent #2 Information
Parent #2 Name*
First Last
Parent #2 Relationship to child*
Parent #2 Phone Number*
Parent #2 Email*
Parent #2 Address (if different than child's)
Street Address City State / Province / Region ZIP / Postal Code Country

Additional Information
Names and ages of other children in the family*
Previous preschool experience?*
- Yes
- No
Name of previous school and teacher*
All students in Pre-K and Preschool must be potty trained by the first day of school. Is your/Will your child be potty trained by the first day of school? Please select "No" if your child is a Preschool Pioneer student.*
- Yes
- No
Any additional information about your child we should be aware of? Special needs, language used at home, family situations, etc*
Emergency Contact*
Please list someone other than Parent #1 or Parent #2 that is available during your child's class in case of emergency.
First Last
Emergency Contact phone number*
Consent*
I understand that every effort will be made to contact the parents of my child, should he/she need medical or surgical treatment. However, if it is impossible to do so, I hereby give my permission to the emergency physician to secure proper treatment for my child.
Name of person giving consent.*
First Last
Date*
MM slash DD slash YYYY
Registration Fee*
When you submit your registration you will be sent a link to set up your Brightwheel App account, where you will then be invoiced a $135 non-refundable registration fee plus a $3.90 processing fee. Your child will not be fully registered or placed in a class until your registration fee is submitted. Please check "I understand" to acknowledge you are aware of this process.
I understand.
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Mid-Year Enrollment the School Year 2025-2026