Anchored Christian Preschool

ANCHORED CHRISTIAN PRESCHOOL
A ministry of Glendale at Cave Mill
1807 CAVE MILL ROAD
BOWLING GREEN, KY 42104
270-781-9077
www.glendalecavemill.com

Directions: Please complete all sections and fill out an application for each child. Each application must be accompanied by a $100.00 non-refundable fee. (Not to exceed $200 per family) Make checks payable to Anchored Christian Preschool. If paying with a credit or debit card, there is a $3.00 convenience fee.

We are grateful for your interest in providing a Christian education for your child(ren) and appreciate your confidence in our school.
The following information should prove helpful.
Current weekly rates are $150.00 per child. There is an annual book & supply fee of $200 per child

To submit an application for admission, the following is required:
*Application for admission completed for each child
*$100 application fee
*Current immunization certificate

Anchored Application
Child's Name:
Child's Name:
First
Middle
Last
Mother's Name:
Mother's Name:
First
Middle
Last
Father's Name:
Father's Name:
First
Middle
Last
Guardian's Name (If Applicable):
Guardian's Name (If Applicable):
First
Middle
Last
Marital Status of Parents:

Parent/Guardian Employment Information

Program Desired:
Days Desired:

Emergency Information

Arrival and Departure Information

Please list below the names of people who are permitted to pick up your child and relationship to the child, if any:

Please list any person who is NOT allowed to pick up your child from this center:

Child's Personal Information Record:

Child's Health History Information:

Please check if your child has any of the following:
How are allergies manifested?

ALL THE INFORMATION ON THIS APPLICATION IS ACCURATELY COMPLETED. I KNOW THAT COMPLETE AND ACCURATE INFORMATION IS NECESSARY IN ORDER TO BEST SERVE MY CHILD. I UNDERSTAND THAT IT IS MY RESPONSIBILITY TO LET THE CENTER KNOW OF ANY CHANGES IN EMPLOYMENT OR RESIDENCE. I HAVE READ AND UNDERSTAND THE PARENT HANDBOOK.

Preferred Hospital:

Anchored Christian Preschool
Emergency Release Form
I, , parent/guardian of, your childs name, give permission to the Anchored Christian School director and/or staff to obtain emergency medical care for while he/she is attending Anchored Christian Preschool.