Neta Lane Preschool

4729 Neta Lane, Wichita Falls, Texas 76305, (940) 761-2103

Wichita Christian School Registration

Student Name

According to his/her birthdate on September 1, my child be be attending
with optional after-school care
Address
City State ZIP
Phone Birthdate Male Female
Father's Name Employer Phone
Mother's Name Employer Phone
Mother's Employer Work Phone

For emergency, please contact:

Relative Name Relative Phone

Friend Name Friend Phone

I authorize my child to be released to:

or or

I give permission for my child to go on school-sponsored field trips during the school year. I understand that my child will travel in a private vehicle driven by a teacher or parent. If I do not want my child to participate in the trip, I will notify the school the day prior to the planned trip.

Parent/Guardian Signature__________________________________________________________________Date____________________________

I give permission for my child to receive emergency medical treatment if necessary from a teacher or administrator of WCS during the school year. This treatment will be administered only in the event that I cannot be located within a reasonable amount of time following an accident that demands treatment.

Parent/Guardian Signature__________________________________________________________________Date____________________________

My child is physically and mentally able to participate in group activities. My child is participating in an ongoing health supervision program with annual evaluations and scheduled immunization.

Parent/Guardian Signature__________________________________________________________________Date____________________________

Please note any physical problems:

Physician's Name Address Phone

Please attach a copy of your child's immunization record and registration fee with this form and mail to:

Wichita Christian School
4729 Neta Lane
Wichita Falls, TX 76302

DAYS
REGISTRATION FEE
MONTHLY TUITION
AFTER-SCHOOL CARE
Tues.-Thurs. 3 yr.
$75.00
$80.00
+$140.00
Mon.-Wed.-Fri. 4 yr.
$75.00
$85.00
+$140.00
Daily 4 yr.
$100.00
$130.00
+$140.00
Daily 3 yr.
$100.00
$130.00
+$140.00

A 5% discount is applied if paid in full before the first attendance day. A family discount on tuition and registration fees applies with families with two or more children.

Please note: Your child's place in class will be secured upon WCS receiving this form and payment of registration fees. Registration fees will not be refunded or applied to tuition.

 

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