Registration
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CDE is excited for year 2 of Fireflies Preschool! Registration will be open to current Fireflies students on 1/1/24, CDE Members on 1/15/24, and to the public on 2/1/24. A $75 non-refundable application fee will be processed with your application. There will be 3 class offerings: 2s Class: T/Th 9am-12pm, 3s Class: M/W/F 9am-1pm, and 4s Class: M-F 9am-1pm
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
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- denotes required fields
Family Information
First Name:
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Last Name:
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Type
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Father
Guardian
Mother
Other
Parent
Home Phone:
Cell #:
Work #:
Email:
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(Emails are kept confidential)
Address:
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City:
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State:
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AK
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AZ
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CO
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DE
FL
GA
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Zip:
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Emergency Contact Info
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Students entered below will be added to your family's account
Add New Student #1:
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Student's First Name:
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Last Name:
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Student Gender:
Female
Male
Birth Date:
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(format=mm/dd/yyyy)
Student Email:
23-24 Grade Level:
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preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #2:
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Student's First Name:
*
Last Name:
*
Student Gender:
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
23-24 Grade Level:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #3:
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Student's First Name:
*
Last Name:
*
Student Gender:
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
23-24 Grade Level:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
23-24 Grade Level:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
23-24 Grade Level:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Questions/Options:
Are you applying for the 2s class? (Must turn 2 by 8/31/24)
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Yes
No
Are you applying for the 3s class? (must be 3 by 8/31/24)
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Yes
No
Are you applying for the 4s class? (Must turn 4 by 8/31/24)
Is your family a current 2023-2024 member of Christy's DancExplosion?
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Yes
No
My reasons for enrolling my child in preschool are:
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Does this child have any fears or phobias?
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Please describe the child's toilet habits/abilities.
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List all allergies (food, environmental, etc.)
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List any medical problems or health conditions.
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List any medications being taken by your child.
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Date of last physical examination.
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Child's Physician Contact Information
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Are there other children in the family? If so, please list names and ages.
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How did you hear about Fireflies Preschool?
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What size T-Shirt do you anticipate your child will need in August 2024? (2T, 3T, 4T, 5T or small 6-8)
Additional Information:
Application Fee
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I understand my card will be charged a $75 non-refundable application fee when the application is submitted. Space is on a first-come, first-served basis. If space is not available for your child, your application fee will be refunded. Applications will be processed for current Fireflies families on 1/1/24, CDE Members on 1/15/24, and public on 2/1/24.
I've read the above and agree.
Tuition
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Application Fee: $75
Monthly Tuition:
2s Class: $297
3s Class: $397
4s Class: $448
Tuition is auto charged to your card on file on the 1st day of each month. A grace period of 4 days is given and fees are considered late after the 5th of the month. A late fee of $25 per student will be posted to your account on the 6th if tuition has not been received.
Children will be dismissed from the program if tuition remains unpaid within 30 days past the due date. Tuition must be paid each month whether the child/ren is able to attend or not in order to hold your spot/s in the program.
I've read the above and agree.
Class Age Requirement
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I understand there are 3 class options.
2s Class: T/Th 9am-12pm. (must be 2 by 8/31/24)
3s Class: M/W/F 9am-1pm. (must be 3 by 8/31/24)
4s Class: M-F 9am-1pm. (must be 4 by 8/31/24)
I've read the above and agree.
Medical Requirements
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I understand I will be asked to submit a copy of my child's vaccination record on or before the 1st day of class.
I've read the above and agree.
Enter your Full Name:
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Other Questions/Comments:
Credit Card Verification:
Card Number:
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Name as it appears on card:
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Nickname:
Card Expiration Month:
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Exp Year:
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2024
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Address Line 1:
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City:
State:
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
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PR
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Zip:
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