Preschool Registration Form *Denotes Required Field * Title Child's Information * Child's Full Name: My child's preferred name in the classroom: * Gender: Male Female * Birthdate: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 * Is your child fully toilet trained? * (No Pull-Ups) Yes Not yet, but will be by September 1st *Please note that preschool students must be fully toilet trained (no pull ups) and independent in the bathroom to attend preschool. This means they can verbalize when they have to go to the bathroom, they can manage taking off and putting on their clothing independently, and can wipe/clean themselves and wash their hands independently. * Will your child be entering Kindergarten in September 2027? Yes No Uncertain * Address: * City: * Postal Code * Parent(s) Name(s): Primary Parent/Guardian Contact Information * Primary Contact Name: * Relationship to child: Occupation: * Main Contact Phone Number (Easiest to Reach): ( ) - Alternate No: ( ) - * Email Address: Church attending (if any): For how long: Secondary Parent/Guardian Contact Information Secondary Contact Name: Relationship to child: Occupation: Main Contact No: ( ) - Alternate No. ( ) - Email Address: Church attending (if any): For how long: 3 & 4 Year-old Program Please Note: Your child must be 3 years old by September 1st, 2026 to attend this class. My child is 3 years old by September 1, 2026. Three classes per week ($1800 per year or $180 per month over 10 months): Monday, Wednesday and Friday mornings (8:45 am - 11:15 am) Tuesday, Thursday and Friday mornings (8:45 am - 11:15 am) Two classes per week ($1400 per year or $140 per month over 10 months): Monday & Wednesday mornings (8:45 am - 11:15 am) Tuesday & Thursday mornings (8:45 am - 11:15 am) 4 & 5 Year-old Program Please Note: Your child must be 4 years old by September 1st, 2026 to attend this class. My child is 4 years old by September 1, 2026 Three classes per week ($1800 per year or $180 per month over 10 months): Monday, Wednesday and Friday afternoons (12:30 pm —3:00 pm) Tuesday, Thursday and Friday afternoons (12:30 pm —3:00 pm) Two classes per week ($1400 per year or $140 per month over 10 months): Monday & Wednesday afternoons (12:30 pm —3:00 pm) Tuesday & Thursday afternoons (12:30 pm —3:00 pm) FEES Payment Plan: *Payments can be made in full or divided equally over ten months, October to June. (September payment is being taken with the registration fee to hold your spot and is non-refundable.) Payment in Full 2-day a week: $1400 per year + $50 registration fee = $1450 3-day a week: $1800 per year + $50 registration fee = $1850 Monthly Payments 2-day a week: $140 per month - October to June (September payment $140 + $50 registration fee = $190 - must be paid in advance to hold your spot) 3-day a week: $180 per month - October to June (September payment $180 + $50 registration fee = $230 - must be paid in advance to hold your spot) Method of Payment (non RCS families): E-transfer (receivables@myrcs.org) Memo: Preschool Fees Cash - Reception Office, Main Campus (2505 23rd Ave.) Cheque - mail to: 2505 23rd Ave. Regina, SK S4S 7K7 Debit - call 306-775-0919, ext 0 to request a PAD Form. Credit Card - call 306-775-0919, ext 0. Method of Payment (current RCS families): Please charge my PAD on file Please charge my Credit Card on file I will call or visit the Main Campus Reception Office to pay. I understand that my first month’s payment and the $50 registration fee are non-refundable. I also acknowledge that I must provide one full month’s written notice to withdraw my child from the preschool, or I will be responsible for an additional month of fees. (For example, if notice is given on January 15th, I am responsible for the remainder of January as well as all fees for February.) * Parent/Guardian Signature Use your finger or mouse to sign in this box. Clear Signature * Date: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025