1. Fill out the Mt. Zion Lutheran Pre-School Registration Form.

2. All registrations and fees ($35) must be submitted to the Mt. Zion Lutheran Church office at 2164 Mt. Zion Road, York, 17406

3. For additional information, please call Mt. Zion Lutheran Church Preschool at 717-757-7626.

AGE GROUPS - THE TWO YEAR OLDS classes are available for children who will turn 2 before September 1st of the current year.

     THE THREE YEAR OLDS classes are available for children who will turn 3 before September 1st of the current year. All children in this class must be potty-trained.

     THE FOUR YEAR OLDS classes are available for children who will turn 4 before September 1st of the current year. All children in this class must be potty-trained.

SESSIONS:

THE TWO YEAR OLDS	(2 sessions per week)
Tuesday & Thursday	9:30 AM to 11:30 AM
**Monday & Wednesday**	9:30 AM to 11:30 AM
THE THREE YEAR OLDS	(3 sessions per week)
Monday, Wednesday & Thursday (Class A)	9:00 AM to 11:30 AM
**Monday, Wednesday & Thursday (Class B)**	9:00 AM to 11:30 AM
THE FOUR YEAR OLDS	(4 sessions per week)
Monday, Tuesday, Wednesday & Thursday	9:00 AM to 11:30 AM
**Monday, Tuesday, Wednesday & Thursday**	12:30 PM to 3:00 PM

**This class will only be available if registration numbers allow for the class to open.

COSTS: REGISTRATION FEE:  $35.00 (non-refundable).  Due at time of registation.

THE TWO YEAR OLDS	2 Sessions Per Week	$90.00 Per Month
THE THREE YEAR OLDS	3 Sessions Per Week	$110.00 Per Month
THE FOUR YEAR OLDS	4 Sessions Per Week	$120.00 Per Month

Registration form for Mount Zion Preschool

Parent/Guardian: Please fill out one form for each child to be enrolled.   

Child’s Full Name: ____________________________________________ Birth Date: _______________

Gender: ___ Male ___ Female      Name by which your child is called: ___________________________

Parent/Guardian Name(s): ______________________________________________________________

Address: _street___________________________________________{apt #}___________________________ 

                  _city_________________________________________state________________zip_______________      

Home Phone: __________________________________          Cell Phone: ______________________

E-Mail Address: ______________________________________________________________________

Parent/Guardian Place of Employment: ___________________________________________________

Family Church Affiliation: _______________________________________________________________

Names and Ages of Siblings: ____________________________________________________________

Does your child have any pets? _______________ _{pet names^{__________________________________________}}      

Does your child have any special interests? ________________________________________________

Has your child previously attended pre-school? _____________________________________________

Special concerns your child may have: ____________________________________________________

___  Allergies (Medicine, Food, Other) – Please Explain: ______________________________________

___  Fears – Please Explain: _____________________________________________________________

___  Sleeping – Please Explain: __________________________________________________________

Other – Please Explain: _________________________________________________________________

___ THE TWO YEAR OLDS              (2 sessions per week)
____________	Tuesday & Thursday	9:00 AM to 11:30 AM
____________	**Monday & Wednesday**	9:00 AM to 11:30 AM
___ THE THREE YEAR OLDS               (3 sessions per week)
____________	Monday, Wednesday & Thursday (Class A)	9:00 AM to 11:30 AM
____________	**Monday, Wednesday & Thursday (Class B)**	9:00 AM to 11:30 AM
___ THE FOUR YEAR OLDS (4 sessions per week)
____________	Monday, Tuesday, Wednesday & Thursday	9:00 AM to 11:30 AM
____________	**Monday, Tuesday, Wednesday & Thursday**	12:30 PM to 3:00 PM

**This class will only be available if retgistration numbers allow for the class to open. 

Please submit application & non-refundable $35.00 registration fee (make checks payable to Mt. Zion Lutheran Church)as soon as possible to:Mt. Zion Lutheran Pre-School,2164 Mt. Zion Rd,York PA 17406.