2021-2022 Small Steps Registration

Class Day Options

2 day (1 yr. olds) FULL* - But, please continue with registration process. You will be contacted if there is enough interest to open another class.
3 day (2 yr olds) FULL* - But, please continue with registration process. You will be contacted if there is enough interest to open another class.
3 day (3 yr olds) FULL* - But, please continue with registration process. You will be contacted if there is enough interest to open another class.
5 day (3 yr olds) FULL* - But, please continue with registration process. You will be contacted if there is enough interest to open another class.
5 day (4 yr olds) FULL - AT CAPACITY

*If there is enough interest in any of the classes that are full, there is the opportunity for us to open new classes.

Extended day options

2 day
3 day
5 day

Child's Info

Child's Name *

First

Last

Child's nickname (if they have one)

Birthday *

Gender

Home Address *

Address Line 1

Address Line 2

City

State

Zip Code

Parent Email *

Home Phone

Dad's Cell Phone

Mom's Cell Phone

Primary Daytime Caregiver's Name

First

Last

Parent Info

Father's Name

First

Last

Father's Employer

Father's Employer Phone

Days and Hours Father is at work

Mother's Name *

First

Last

Mother's maiden name

Mother's Employer

Mother's Employer Phone

Days and Hours mother is at work

Family Info

Are parents married or divorced? *

Do both parents live with the child? *

Are there any person(s) who are not allowed contact with your child? If so, list them below

Are you a member of FBC Enterprise? *

If not, where do you attend church?

Would you like FBC to contact you about services or programs?

Medical Info

List all allergies (food and medications)

List all current/previous medical conditions

Fees & Registration Information

Registration Fee and Supply/Snack Fee are due when you submit your application and are non-refundable upon admission.Registration Fee: $50 per family;Supply/Snack Fee: $125 (5-Day); $100 (3-Day); $75 (2-Day); $50 (extended day).Small Steps Tuition: 5-Day: $220; 3-Day: $170; 2-Day: $120.Additional Tuition for Extended Small Steps 5-Day: $120 3-Day: $100 2-Day: $90.

Parent Signature *

By typing your name above you are agreeing to the release of the information you provided for this online form. You are also agreeing that all of the information contained in this form is correct. You understand that completing this application does not mean your child is registered. You will be contacted regarding the registration process if your child is admitted to Small Steps.

Date *

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