Avon Grove Academy

2025-2026 Registration IS OPEN

**Complete one form for each child**

***Read the following information carefully***

1. Submit this form on-line. (Please respond to every line!)

2. Mail or bring in the non-refundable registration fee of $100.

3. Tour the Center and meet our staff.

4. You will receive a message that this form was sent.

5. You will receive e-mail confirmation of enrollment within 3 weeks.

Please note: A current Health Assessment Form completed by your child’s physician and confirming that your child has been seen by a physician within the past 12 months must be on file before the first day.

**Requirements for Classes**

CHILDREN MUST BE POTTY TRAINED

1. Pre-school - Age 3 by September 1st

2. Pre-Kindergarten - Age 4 by September 1st

3. AGNA Kindergarten - Age 5 by September 1st

If enrollment for any class has not reached a total of 6 children by July 1, parents will be notified and given the option of enrolling in another appropriate class or having their registration fee refunded.

Registration Form

Child's First Name

Child's Last Name

Date of Birth

Parent/Legal Guardian Name

Phone Number of Parent/Guardian

Email of Parent/Guardian

Address of Parent/Guardian (Street, City, State, Zip)

Childhood Vaccinations Up To Date?

Allergies/Special Needs?

If Yes, What Are They?

Current Medications?

If Yes, What Are They?

Does Your Child Have an IEP? If YES, please provide a copy.

Sibling 1

Sibling 2

Sibling 3

Has Your Child Visited AGNA?

Have Your Other Children Attended AGNA?

Allow Child's Picture (Website/Facebook)?

Has Your Child Previously Attended Preschool?

If Yes, Where?

Parental Status

If Divorced/Separated, Please State Visiting Arrangements

Is Either Parent Deceased?

Is Your Child Adopted?

If Yes, At What Age?

Does Your Child Attend Sunday School/Church

If Yes, Where?

More info about our church?

Full Payment or Blackbaud Tuition Management?

Pre-school Class Sign-up

Pre-kindergarten Class Sign-up

AGNA Kindergarten Sign-up

Preschool/PreK/K Early Birds (7:00am - 8:30am)

Yes

SCHOOL AGE CARE What Public/Charter School will your child attend?

What Grade Will Your Child Enter?

SCHOOL AGE CARE

Comments

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