There is a $50 registration fee and a $450 deposit per student. These fees are non - refundable.

Child’s Last Name:__________________________________________

Child’s First Name:__________________________________________

Child’s nickname, if any: _____________________________________

DOB: Boy Girl

Address:__________________________________________________

_________________________________________________________

City _______________________ Zip Code _____________________

Home Email:_______________________________________________

Parent 1 Full Name:__________________________________________

Parent 1 Cell Phone:_________________________________________

Parent 1 Work Phone:________________________________________

Parent 2 Full Name:__________________________________________

Parent 2 Cell Phone: _________________________________________

Parent 2 Work Phone:________________________________________

Parent 1 Email: _____________________________________________

Parent 2 Email:_____________________________________________

Does your child have any special needs, receive Birth to 3 services, or have an IEP?
__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

Food allergies or other health concerns?__________________________________

__________________________________________________________________

__________________________________________________________________

Is your child: a Returning Student SCP Sibling Member of SC Church New Student

Other child/children who may wish to attend SCP: Name DOB

Class Days Tuition Deposit 5/1 10/1 2/1

2-year old class T/TH $4675 $450 $1409 $1408 $1408

2-year old class M/W/F $5850 $450 $1800 $1800 $1800

3-year old class T/TH $3325 $450 $959 $958 $958

3-year old class M/W/F $4950 $450 $1500 $1500 $1500

4-year old class M/T/W/F $5875 $450 $1809 $1808 $1808

4-year old class M - F $6550 $450 $2034 $2033 $2033

5-year old class M - F $7975 $450 $2509 $2508 $2508

Check No. _______ Check Date _______ $ _______ Date of Enrollment___________ (School Use ONLY)

524 Pequot Avenue Southport, CT 06890 203-255-131

CONDITIONS OF REGISTRATION AND TUITION PAYMENT POLICY

1.Registration

The registration form must be completed and accompanied by a $50 registration fee and a

tuition deposit of $450. These fees are non-refundable in the event the student is withdrawn.

The registration fee will not be deducted from the year’s tuition.

2. Tuition Schedule

The balance of the year’s tuition will be made in three payments, due no later than:

May 1, 2022

October 1, 2022

February 1, 2023

For your convenience, a statement will be sent out a week prior to these due dates to

remind you that tuition is due. However, you are responsible for paying tuition by the due

date whether the statement is received or not. The registrant is responsible for any

returned check fees.

Tuition can be paid by check, or to pay by credit card please use the link for Southport

Congregational Preschool on the Southport Congregational Church website.

3. A $50 late fee will be assessed for tuition payments not received within two weeks of the due

date. If the tuition and late fee are not received within four weeks of the due date, the child

will not be allowed to attend the program until all balances are paid. No child will be admitted

to class unless the required tuition payments have been made.

4. Registration to Southport Congregational Preschool is for the entire school year and the

registrant is obligated to pay the full year’s tuition. No exceptions will be made for absence

or withdrawals for any reason during the year.

5. ___ (PLEASE INITIAL) Tuition is non-refundable. I have read and understand the Conditions

of Registration and Tuition Payment Policy.

I accept the conditions stated above and register my child at Southport Congregational Preschool

for _____ days per week at $___________ per year.

Parent’s Signature __________________________________________________ Date_________