Early Childhood Education Registration Application Home + Early Childhood Programs + Early Childhood Education Registration Application Early Childhood Education Registration Application JCC Brooklyn — Windsor Terrace Choose Program Choose Program Preschool program (2-4 years) Infant - Toddler (12-24 months) Child's Information Child's Gender * Male Female State Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah U.S. Virgin Islands Vermont Virginia Washington West Virginia Wisconsin Wyoming Armed Forces Americas Armed Forces Europe Armed Forces Pacific Household 1 Parent/Guardian Household 2 Parents/Guardians Household Parent/Guardian 1 Parent/Guardian 2 Sibling 1 (optional) Male Female Sibling 2 (optional) Male Female Emergency Contact 1 Emergency Contact 2 Applicant Status Applicant Status First Time Applicant Returning Student Has your child previously been enrolled or is he/she currently enrolled in a daycare or preschool? * Yes No Schedule Options September 2026 – June 2027. School will begin after Labor Day. Our preschool is open from 8:00 am to 6:00 pm. Please choose options below. Number of Days per Week Two Days (Tues, Thurs only) Three Days (Mon, Wed, Fri only) Five Days Days of the Week * Monday Tuesday Wednesday Thursday Friday Days of the Week * Monday Wednesday Friday Days of the Week * Tuesday Thursday Daily Hours * Full Day 8:30am - 3pm Half Day 8:30am - 12pm Extended Care Options Early Bird Dropoff (8am) Zero Days One Day Two Days Three Days Four Days Five Days Early Bird Days of the Week * Monday Tuesday Wednesday Thursday Friday After-Care (3:00-6:00) Zero Days One Day Two Days Three Days Four Days Five Days After-Care Days of the Week * Monday Tuesday Wednesday Thursday Friday Tell Us About Your Family PJ Library * Yes! Please sign up my child(ren) for free Jewish books from PJ Library. Yes! We already receive PJ Library for one child, but our other child(ren) is not yet signed up. Please sign them up for their own age-appropriate books. Every child in our home already receives their own PJ Library book. My child(ren) has aged out of PJ Library. PJ Library is not the right fit for my family. We welcome your involvement in our community. Please indicate if you would like to be contacted for involvement. * Yes No Terms of Enrollment 1) Medical forms and immunization records must be current within 30 days of the start of the child’s first day of school. Medical forms are current for one full year from the exam date. 2) JCC- Brooklyn will not be responsible for damage to or loss of personal property. 3) Our program aims to provide all participants with a healthy and safe environment. If a participant displays any inappropriate behavior or endangers the health and safety of participants or staff, we will contact the parent/guardian to come to the site immediately. We may suspend the participant from the program or consider permanent termination in extreme situations. 4) All payments are due on or before the first of the month. 5) Statement of Non-Refundable Deposit: After a child is accepted to the JCC Brooklyn Early Childhood Program, a non-refundable deposit is necessary to secure a place for your child on the class list. This deposit will be credited towards tuition fees and applied to the first and last months’ payments and the total amount for the activity fee. No partial refunds of deposits or exceptions will be made to this policy. 6) A service charge of $250 will be applied for any refunds or cancellations, for any payments made after the submission of the deposit and activity fee payments. 7) Applying with a registration fee does not guarantee your child’s space in the school. Admission is granted based on the order in which applications were received and the requested schedule (flexibility helps). Your child’s space is secured once each deposit and the full activity fee have been received. 8) THE ENROLLMENT INTO OUR PROGRAMS IS FOR A 10-MONTH SCHOOL YEAR. THERE ARE NO TUITION REFUNDS for ANY REASON. If parents choose to withdraw their child from the program before the end of the school year, all tuition payments paid to date are forfeited and you are required to make scheduled payments while enrolled. Parents are still responsible for preschool tuition if a child is absent for an extended amount of time. 9) Make-up days are not allowed regardless of school closings, holidays or absences for any reason. I agree to the Terms and Conditions I hereby permit my child to participate in all programs, activities and trips. I understand and fully recognize that risks are involved. I hereby release JCC Brooklyn or any of its sponsors, benefactors, or employees from any liability arising from any injury to my child in the event of a medical emergency or surgical emergency. I do hereby give authority to the program and staff to obtain necessary emergency medical treatment for my child, understanding that the family will be notified as soon as possible. I grant permission to the physician designated by JCC Brooklyn to hospitalize, secure proper treatment for, and order injections, anesthesia or surgery for my child. Furthermore, I understand that payment for medical services is solely the family’s responsibility. I hereby permit JCC Brooklyn/ Kings Bay YM-YWHA, Inc. to take photographs of me and/or my child to be shown in a video, brochure, advertisement, or internet display for purposes of promoting interest in JCC Brooklyn. I release the JCC Brooklyn/Kings Bay YM-YWHA, Inc. from any claims resulting from the pictures taken on, before, or after the date of this communication. I do hereby permit for my child to participate in all activities, including off-ground activities. I authorize JCC Brooklyn/ Kings Bay YM-YWHA, Inc. to act as a parent surrogate on my behalf. I realize that itineraries and/or programs are subject to change before, and during the year. I agree to the Release All applications are reviewed on a first-come, first served basis. $100 non-refundable registration fee must be submitted before an application can be considered for enrollment. Enrollment is determined based on a variety of factors, including date of application, child’s date of birth, and schedule availability. Acceptance notices and contracts will be sent via email (hard copy on request). Registration Fee Payment Total: $100.00 Exp. Month010203040506070809101112 Exp. Year20262027202820292030203120322033203420352036203720382039204020412042204320442045 SUBMIT APPLICATION