Enrollment

Tuition: 

  • 0 – 12 months: $190 per week
  • 13 – 24 months $170 per week
  • 25 – 36 months $160 per week
  • 37 – 48 months: $150 per week
  • 49 – 60 months $140 per week

Please call for part-time prices

Parent/Guardian Information

Name(Mother or Guardian #1):

Mother's Cell Phone:

Mother's Email:

Mother's Adress:

Mother's Place of Employment:

Mother's Work Phone:

Name(Father or Guardian #2):

Father's Cell Phone:

Father's Email:

Father's Adress:

Father's Place of Employment:

Father's Work Phone:

Registration Information

(Please register each child separately)

Child's First Name*:

Child's Last Name*:

Gender*:
 Female Male

Nickname:

Street Adress*:

City*:

State*:
Zip Code*:

Child Resides With:
 Mother Father Both Neither
Neither:

Custody or Visitation Guidelines:

Home Phone*:

Emergency Contacts

Emergency Contact #1::

Relationship to Child:

Emergency Phone:

Emergency Contact #2::

Relationship to Child:

Emergency Phone:

Release Information

If I am unable to pick up my own child, I give permission for my child to be released to the following individuals:

My Child MAY be released to Contact #1

Name:

Relation to Child:

Phone Number:

My Child MAY be released to Contact #2

Name:

Relation to Child:

Phone Number:

My Child MAY be released to Contact #3

Name:

Relation to Child:

Phone Number:

My Child MAY be released to Contact #4

Name:

Relation to Child:

Phone Number:

NON-Release Information

My child may NOT be released to the following individuals listed below.

My Child may NOT be released to the following individual

Name:

Relation to Child:

Physical Description:

Other important information:

My Child may NOT be released to the following individual

Name:

Relation to Child:

Physical Description:

Other important information:

I understand that all persons picking up my child from school MUST show proof of their identity with a valid Driver’s License. If they are unable to produce valid identification, the Lily School staff will NOT release my child into that individual’s custody.

Upon final registation with the Lily School staff you will sign acknowledging you understand the above statement.