Preschool Application August 2023 – May 2024 Child's InformationChild's Name(Required) First Last Date of Birth(Required) Month Day Year Age(Required)Gender(Required)Previous Child CareFamily ChurchPrimary Payer(Required)Days AttendingFull or Half Day(Required)Full DaysHalf DaysDays of the Week(Required) Monday Tuesday Wednesday Thursday Friday Father/Stepfather/GuardianName First Last Email Address Street Address City State / Province / Region ZIP / Postal Code Home PhoneCell PhoneCell Phone CarrierEmployerTitleWork PhoneMother/Stepmother/GuardianName First Last Email Address Street Address City State / Province / Region ZIP / Postal Code Home PhoneCell PhoneCell Phone CarrierEmployerTitleWork PhoneAny other children?(Required)YesNoPlease list other children's names and agesDoes your child use the restroom independently?(Required)YesNoA one-time non-refundable registration fee of $75 per student must accompany this application. KCS accepts children in all its programs, regardless of race, creed, color, national origin or religious beliefs, as space allows, according to enrollment requirements and policies.Signature (Type your full name)(Required)Relationship to Child(Required)Date(Required) Month Day Year CAPTCHA