Registration Form

Preschool Enrollment Form

Student Information

Pursuant to the Internal Revenue Service (IRS) regulations, Mount Vernon Baptist Church Preschol is required to file an Annual Certification of Racial Nondiscrimination (Form 5578). Identification is requested but not required.

Parent / Guardian Information

* Only necessary to complete if different from Parent One
If yes, a copy of the most current order must be in the child’s file. If an order is in place, and a biological parent who is not allowed to pick the child up, the appropriate authorities must have the order presented to them or the authorities will allow the parent who is not on the order to take the child if they can prove that he/she is the biological parent. A copy of a current order is critical to have in the child’s file, in the event proof must be shared with authorities if the unauthorized parent attempts to pick up.

Medical Data

Insurance Information

Financial Information

**Please indicate who is responsible for all financial obligations to MVBCP: