Scarsdale Congregational Church Nursery School 4s Class Registration Form
THIS APPLICATION IS FOR THE 2023-2024 *FOURS* PROGRAM, which is a half-day program in session Monday-Friday. If you are not applying for a spot in the 5-DAY FOURS program, please close out of this form and go back to www.sccnurseryschool.com/admissions to select the appropriate application form.  
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Email *
STUDENT INFORMATION
Student Name:  *
Student Nickname (if preferred over full name):
Student Date of Birth:  *
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Student Address (Street number / name):  *
Student Address (Town or City, State):  *
Student Identifies as:  *
PARENT/CAREGIVER INFORMATION
Parent/Caregiver 1 Name:
*
Parent/Caregiver 1 Email:
*
Parent/Caregiver 1 Phone (Please enter in XXX-XXX-XXXX format):
*
Parent/Caregiver 2 Name:
Parent/Caregiver 2 Email:
Parent/Caregiver 2 Phone (Please enter in XXX-XXX-XXXX format):
Do you consent to share your family contact information with classmates on a class list?
*
AFFIRMATIONS
Please read and confirm the below. If you have any questions or concerns please contact the school at 914-723-2440 or sccnschool@gmail.com to discuss.
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I understand and agree
I understand that occasionally a student requires more care and attention than SCCNS is reasonably able to provide, and SCCNS reserves the right to determine whether a child’s admittance or continued attendance in the program is appropriate.
In so registering my child, I recognize my responsibility to cooperate with the school by observing all health regulations, school protocols, and financial obligations.
A payment in the amount of $800 is required at the time of registration. This payment is comprised of a $300 non-refundable registration fee, and a $500 deposit which will be applied toward tuition. One half of the remaining balance is due on April 1st, and the other half on November 1st. If a student withdraws and we are able to fill the vacancy, the school will reduce the obligation to pay the full tuition on a prorated basis from the time the vacancy is filled. I understand payment must be made on the same day this application is submitted, or my child’s spot will be forfeited.
I understand I am responsible for completing a medical form and submitting my child's vaccination records within a reasonable time period and prior to the first day of school.
A copy of your responses will be emailed to the address you provided.
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