MEDINA CITY SCHOOLS HELPING HANDS PRESCHOOL PRE-REGISTRATION FORM FOR NEW PEER MODELS 2016-2017 SCHOOL YEAR This is a tuition based preschool program.

Child’s Name: _____________________________________________ Male

Female

Date of Birth ________________________

Parents: _________________________________________________ Address: _________________________________________________ Mom cell Phone: __________________ Dad Cell Phone: ____________________

We have previously had a child attend Helping Hands Preschool. Child’s Name______________________ Year Attended _____________ **Session preference will be taken into consideration. However, class assignment will be made at the discretion of the Helping Hands staff in order to develop the best groupings for each session. In addition, our morning sessions typically have much younger children enrolled. Please consider an afternoon session if your child will be moving on Kindergarten the following year**

Sessions are Monday thru Thursday. Each session is 2-½ hours long. Exact times of each session are determined prior to the upcoming school year. For the 2015-16 school year our times are 8:55-11:25 a.m. and 12:50-3:20 p.m. AM Session (2 ½ hours) PM Session (2 ½ hours) PLEASE NOTE THAT PRESCHOOL PEERS DO NOT RECEIVE TRANSPORTATION TO AND FROM SCHOOL EACH DAY. TRANSPORTATION IS THE RESPONSIBILITY OF THE PARENT FOR PEERS IN THE HELPING HANDS PRESCHOOL PROGRAM. New Peer Model Enrollment begins February 1, 2016. Pre-Registration forms are processed on a first-come, first-serve basis by the date that they are received in our office. Every attempt will be made to place children in the session preference indicated on the pre-registration from. Please return this form:

Kathy Loop Helping Hands Preschool Eliza Northrop Elementary 950 E. Reagan Parkway Medina, OH 44256

If you have any questions or would like more information, please contact our office at (330) 636-4601.