JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
ELC Summer Registration Application
June 1, 2020 through July 31, 2020
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Summer Session Fees - All fees are due at enrollment.
New Student Registration - $75
Returning Student Registration $50
Supply Fee $125 (New students only)
Registration fee is non-refundable.
Pay Online (due NOW)
Click the link and register for ShelbyGiving (if you have not already), in order to make your Registration payment NOW! We are ONLY accepting ONLINE payments at this time. Any current accounts that are behind, must be caught up before being permitted to register for this new session. Make all payments through the link below.
https://www.shelbygiving.com/App/Form/8ddd65ea-f1e8-4329-a472-942c21f24601
#1 Child's First and Last Name
*
Your answer
#1 Child is:
*
New Student
Returning Student
#1 Child
*
Boy
Girl
#1 Child's Birth Date
*
MM
/
DD
/
YYYY
We are accepting school aged siblings - limited space
New Student Registration Fees Apply
#2 Child's First and Last Name
Your answer
#2 Child is:
New Student
Returning Student
Clear selection
#2 Child
Boy
Girl
Clear selection
#2 Child's Birth Date
MM
/
DD
/
YYYY
#3 Child's First and Last Name
Your answer
#3 Child is:
New Student
Returning Student
Clear selection
#3 Child
Boy
Girl
Clear selection
#3 Child's Birth Date
MM
/
DD
/
YYYY
Street Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
Subdivision
*
Your answer
School District
*
Your answer
Home Phone
*
Your answer
Mom's Name
*
Your answer
Mom's Cell Phone Number
*
Your answer
Mom's Work Phone Number
*
Your answer
Dad's Name
*
Your answer
Dad's Cell Phone Number
*
Your answer
Dad's Work Phone Number
*
Your answer
PROGRAM OPTIONS
Please check your choice
PRE-SCHOOL ONLY (9:30 a.m. - 2:30 p.m.) - All ages *Pre-K must be 4yrs by 9/1, & requires 3 or 5 days only
5 Days - $497/m
3 Days - $372/m
2 Days - $265/m
Clear selection
FULL DAY Pre-School Program (6:30 a.m. - 6:00 p.m.) - All ages *Pre-K must be 4yrs by 9/1, & requires 3 or 5 days only
5 Days - $691/m
3 Days - $544/m
2 Days - $419/m
Clear selection
EXTENDED CARE FEES (this applies if you are not participating in the full-day program)
AM Extended only (6:30 a.m. to 9:30 a.m.) $118/m
PM Extended only (3:00 p.m. to 6:30 p.m.) $166/m
Do you want to add Extended Care (if you chose a Pre-school only option)?
Yes
No
Clear selection
If "EXTENDED CARE" is needed what times do you anticipate drop-off and pick-up to be?
Your answer
Check which days of the week for 2 and 3 day program.
Monday
Tuesday
Wednesday
Thursday
Friday
Billing
All accounts will billed on June 1, 2020, according to your selected program options. Payments will be received online, via ShelbyGiving:
https://www.shelbygiving.com/App/Form/8ddd65ea-f1e8-4329-a472-942c21f24601
Any accounts carrying a past-due balance will not be allowed to register for this session until the account balance is caught up.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Graceview Baptist Church.
Report Abuse
Forms
