Please feel free to print out the form below to mail or
bring in or complete for online registration.
Trinity Lutheran Church
Child Development Center
10355 Palmer-Wasilla Hwy Suite #103, Palmer, Alaska 99645
(907) 745-LOVE (5683)
Please
choose
your
preferred
class time
from the
following
3-4
year old
classes
Please check
preference
Tu/Thur 9:15-11:45 am
Wed/Fri 9:15-11:45am
4-5
year old
classes
Please check
preference
Tu/Wed/Thur 9:15-11:45 am
Tu/Wed/Thur 1-3:30 pm
Child's Name-
Boy
Girl
Date of Birth
Parent/Guardian Name (include Last name)
Home Phone
Mailing Address:
Mother: Cell Phone
Zip
City
Mother: Work Phone
Email Address:
Father: Work Phone
Yes
No
Are you interested in
car-pooling?
Father:Cell Phone
If interested in Car-pooling, general area where you live
Does child have any allergies ( foods, medicines, animals) or have special needs? Please specify
Name of Home Church
How did you hear about this program?
For office use only: Deposit received___Date received___ Check#________
Sorry, our morning class for 4 yr olds is currently full
. Please do not
complete an online application for this class. To find out about more options
available and to be sure that your online application has been received for
other classes, please call 745-5683. Thank you for registering. In order for
the registration to be considered complete your deposit must be received
and acknowledged by the preschool.