Beth-El Zedeck Early Childhood Center

2024-2025 Registration Inquiry Form

Form Login Account (optional)

New Users / Returning Users CLICK HERE to setup or return to your account for this form. Creating an account enables you to return to this form and your submitted results. An account will also enable you to partially complete this form and return later to finish the form. The account you establish is only for this form.

Child's First and Last Name *

Date of Birth (mm/dd/yy) *

Age as of August 1, 2024 (Years and Months): *

Parent 1

Name *

Home Phone

Cell Phone *

Email *

Street Address *

City *

State *

ZIP *

Parent 2

Name

Home Phone

Cell Phone

Email

Street Address

City

State

ZIP

General Information

Household Religious Affiliation (please choose all that apply) *

Please include any additional information we should know:

Class Options

Please do not pay your registration fee until you've been contacted via email from Beth-El Zedeck confirming your child has a spot in the class. Paying the nonrefundable $150 enrollment fee registers your child for our 2023-2024 school year.

Choose dismissal time for 9 months +, 18 months +, and 2 years + only. (Please select 3:00 for 3 years + and Pre-Kindergarten, as they do not have early dismissal.) *

12:30 p.m. dismissal

3:00 p.m. dismissal

9 months + (minimum 2 days)

18 months + (minimum 2 days)

2 years + (minimum 2 days)

3 years + (minimum 2 days, all with a 3:00 p.m. dismissal)

4 years + / Pre-Kindergarten with a 3:00 p.m. dismissal

5 days (Monday through Friday)

3 days (Tuesday, Wednesday, Friday)

Early and After Care

Mark day(s) you wish to have early care for your child. Children in early care may be dropped off any time between 7:30 and 8:50 a.m. Early care is $13/day.

Mark day(s) you wish to have after care for your child. Children in after care may be picked up any time between 3:00 and 6:00 p.m. Monday through Thursday and 3:00 and 5:30 p.m. on Friday. After care is $27/day.

*All Children Must Be Immunized to Enroll at Beth-El Zedeck Early Childhood Center. If your child has a known contagious disease, it must be disclosed to us with the registration form. (This child will be accepted only upon our discretion.)*

Note: The schedule you enter on this form is the schedule we will use to determine staffing. ANY SCHOOL YEAR SCHEDULE CHANGES (which also includes dismissal time changes and ) MADE AFTER June 16, 2024 WILL INCUR A $50.00 CHANGE FEE PER CHILD, PER CHANGE.