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Registration Form
Rochester Cooperative Preschool, Inc.


Today's Date _________________
Child's Name_______________________________________________________________
            (last)                   (first)            (middle)
Name Called________________ Date of Birth___________
Address____________________________________________________________
           (street)                        (city)          (zip)      
Home Phone(      )______-________
Mother's Name_____________________________ Business Phone(     )_____-______ ext.______
Father's Name_____________________________ Business Phone(     )_____-______ ext.______


Tuition for Three Year Old class (Tuesday and Thursday) $45.00 per month*
Tuition for Four Year Old class (Monday, Wednesday, and Friday) $60.00 per month*

Please check your preference:

_______ I am will to help in my child's classroom.

_______ I am NOT willing to help in my child's classroom.
*Tuition rates for non-helping parents are higher.

*No child will be released from school except to parents.

*Every possible precaution will be taken to safegaurd your child, but in case of an accident, the undersigned releases the Rochester Cooperative Preschool from liability. This release applies not only to the preschool day, but also to any scheduled field trips. All field trips will be announced well in advanced.


Parent's signature____________________________________
**Application consideration will be on a first come, first serve basis.

Please return this completed along with a $25.00 non-refundable registration fee to:
Rochester Cooperative Preschool
1892 East Auburn Rd.
Rochester Hills, MI 48307
(248)852-0861


**Please make check or money order payable to: Rochester Cooperative Preschool
THANK YOU!!!
NON-PROFIT / NON-DISCRIMINATORY



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