FORMS

There are a number of forms required to be on file before your child can begin school. Forms can be mailed in or dropped off at the Preschool (there is a locked mailbox outside of the Preschool entrance for Preschool use only that is available 24 hours a day, 7 days a week for dropping paperwork off).  Children whose files are not complete will not be permitted to attend school until all forms are submitted.   

Registration forms for 2021-22 School year!
  1.  2021-22 Preschool Application   All applications need to be printed out, completed, signed/dated
      and either mailed to HUMC Preschool Registration: 701 Bennett, Herndon, VA 20170 or can be dropped in the secure locked box
      outside the preschool main door, (back of church).  HUMC Preschool is not responsible for lost or delayed mail.

Due June 1, 2021 (or at time of registration if registering after June 1):  

  2.   2021-22 Preschool Contract , Covid-19 Addendum --Please review HUMC Preschool Handbook before signing.

        (Parents of 2 year old's,  please review the Two Year Old  Addendum in addition to the Handbook) 

  3.  Authorization for Emergency Treatment  - This form should be completed online.  *When completing this form, please
     
provide TWO additional Emergency Contacts other than parents. Examples of Emergency Contacts can be: a neighbor,
      (local) family member or friend, coworker, etc. In case of an emergency we will always call the parents first, but due to
      licensure, we do need two additional emergency contacts. 
This is one of the most important forms for us to have on file and it
      is imperative that we have the most up to date information.  If any of the information changes after your file is submitted, please
      complete an Information Change Form and submit it to the Preschool office.    This online form is completed and stored in our G-
      suite account.  G-suite is a product of Google that incorporates advance security and privacy functions.  The data stored in our G-
      suite is HIPPA compliant, owned by us, not Google, and is not scanned for Google advertising or sold to third parties. 

  4.  Advance Tuition Payment - This payment is equal to one month's tuition and is applied to your LAST tuition payment of the year
       (typically May of 2022).  

Due No Later Than August 26, 2021 (or at time of registration if registering after 9/1):

  5.  Health Form (new students only; updates as necessary for returning students)

  6.  Proof of Identity (new students only) - PLEASE PLAN AHEAD FOR YOUR PROOF OF IDENTITY.  For all NEW students, parents must
       bring proof of their child’s identity (original documents) and age to the Preschool office for verification before the beginning of the
       school year.  Proof of Identity may include:

 

  • A certified copy of the child’s birth certificate,

  • Birth registration card,

  • Notification of birth (hospital, physician, or midwife record),

  • Passport

 

**If you need to order a Birth Certificate, please contact the Department of Health in the State where your child was born. In Virginia you can contact 804-662-6200 or www.vdh.virginia.gov or visit your local DMV.  

  7.  Medication Authorization Form if necessary  - Please click here to review the medication requirements

Optional Forms: 

2021-2022 Lunch Bunch Form

If you would like to authorize HUMC Preschool to automatically withdraw tuition from your bank account on a monthly basis, please complete this ACH DEBIT AUTHORIZATION