Jacob’s Ladder Preschool Registration Form 2025-2026

Child's Full Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Mother / Guardian's Name *

First Name

Last Name

Mother's Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Mother's Phone *

(###)

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Father / Guardian's Name *

First Name

Last Name

Father's Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Father's Phone *

(###)

###

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Class Options - Choose One *

3 Year Old Class. Child must be 3 by Oct 15th, 2025. This class is Tuesday & Thursday 9am - 11:30am. Cost: $175/month *This class is designed for the younger 3's as it's more of an introduction to Preschool*

3 1/2 - 5 Year Old Class. Child must be 3 by March 1st, 2025. This class is Monday, Wednesday, & Friday 9am - 11:30am. The cost is $225/month.

3 1/2 - 5 Year Old Class. Child must be 3 by March 1st, 2025. This class is Tuesday, Wednesday, & Thursday 12:45pm - 3:15pm. The cost is $225/month.

Preferred Method of Communication *

Email

Phone

Mail

In Person