Jacob’s Ladder Preschool Registration Form 2025-2026

Registration Fee: $125.00 ($50 goes towards first month’s tuition) Non-refundable and required at the time of registration.

You can make your registration fee payment HERE.

Child's Full Name

First Name

Last Name

Date of Birth

MM

DD

YYYY

Gender

Preferred Name

Member of Ezekiel Lutheran Church?

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

(###)

###

####

Mother's Email Address

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

(###)

###

####

Father's Email