Kessler Park Day School Registration (Wait List Only) for children 3 months through 5 years old. Please make note that Day School registration is on a first come, first served basis. Registration must be completed by a parent or legal guardian.
Please fill out this form and click submit.
Today's Date:
*
Students can sign up for the following options - check one:
*
Please select all that apply.
Monday through Friday (5 days)
Monday/Wednesday/Friday (3 days)
Tuesday/Thursday (2 days)
Child's Name:
*
Child is Called:
*
Gender:
*
Please select one option.
Male
Female
Other
If Other Gender, please identify preferred pronouns:
Birthdate:
*
Main Phone:
*
Main Email:
*
This address will receive a confirmation email
Address, City, State, Zip
*
--
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Parent's Name:
*
Parent's Address (if different), N/A if not different:
*
--
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Parent's Cell Phone:
*
For additional information and space availability, please contact the PDO Director at 214-942-0098, Ext 1 or PDO@kpumc.org.
Submit
Description
Please fill out this form and click submit.
×
Please Fix the Following