Preschool Registration Form - Enroll Your Child Today

Preschool Application Form

Enroll your child today for a bright and joyful learning experience at our preschool.

Class of choice - Choose ONE

TWO Day Tots Class 2/3 year olds

TWO Day New Beginnings Class 3/4 year olds

THREE Day PRE-K 4/5 year olds

Child's Name*

Name you wish your child called?

Date of Birth*

Gender

Male

Female

Address: Street address (apt) , City, zip code

Lives with:

Mother

Father

Both

Mother's Name

Address, if different than child's

Phone Number*

Can we text you at this number?*

YES

NO

Place of Employment (for emergency contact)

Father's Name

Address, if different than child's

Phone Number*

Can we text you at this number?*

YES

NO

Place of Employment (for emergency contact)

Parent's Email Address*

Any Allergies, Special Needs, etc.

Additional Information:

Name of Emergency Contact, if you cannot be reached

Relationship to child?

Phone Number:

Daycare Provider's Name

Address:

Phone Number

Child's Physician:

Phone Number

Can we add your contact information on a class roster for distribution to other classmates?

Yes

No

We are dedicated to providing a nurturing environment for your child's early education and development. Join us in shaping bright futures through our engaging preschool programs.

Join us in prayer and community service today.

Send us an e-mail:

Preschool Application Form

Call us at: 425-334-0421

Latest Update: 6/16/2026

mail to:

2111 117th Ave NE

Lake Stevens WA 98258