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* Child 1 Name

* Child 1 Birthdate

Child 2 Name

Child 2 Birthdate

* Parent 1

* Parent 1 Email

* Primary Phone Number

Cell Phone preferred

* Address Parent 1

Parent 2

Parent 2 Email

Parent 2 Cell

Parent 2 Address

If different than Parent 1

* Class(es) Child(ren) attending: All classes meet 9:00am to 1:00pm ($850 per month):

2's Class (age 2 by Sept 7th)

3's Class (age 3 by Oct 1)

Pre-K (age 4 by Oct 1)

Kindergarten

* If you would be interested in additional extended hours, please indicate your preferred hours below.

Additional extended hours may be available ONLY if there are enough families interested and teachers available.

* Tuition Total - please add the total cost for regular and extended hours:

To be billed at the beginning of the month in which it is incurred. Final amount will vary as extended hours will be calculated per month based on the actual number of days.

* I understand that a one time Commitment Fee of $150 per child will be charged to my account now to hold my spot.

Yes

Due to limited enrollment, if you are delaying enrollment beyond September, $150 will be due each month in order to hold your child's spot.

* Enter the total number of children enrolling.

* I also agree that the Tuition Fees will be automatically charged to my account.

Yes

All tuition will be charged on the 1st of the month, with the first tuition payment due on September 1st.

Additional Information

This will be billed as a recurring payment. The Commitment Fee is due in full *today*, so please select *1 payment* below to pay that amount.

Tuition will be billed monthly on the 1st of the month (or the first business day thereafter.)

Recurring Payment

Thank you for setting up your online billing account for Congregation Beth Chaim Pre-School. Please note that the payment of the $150 commitment fee is due now. Please select *1* recurring payment to pay $150. No registrations will be accepted without payment of the commitment fee in full. Tuition will be charged on the 1st of each month to the account you provide.

I want to make a recurring payment

Please enter the number of periods

Please bill me each period in the amount of

I agree to have my account information used to bill me as per the terms above. Additional payments will be made until the total number of periods are reached.

Recurring Total:

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Account

Online Fee:

Beth Chaim Pre-School

Recurring Payment

Account Details

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