Summer 2024 Pre-Registration

TUITION: $130 /Weekly (includes a weekly music lesson and 4 meals per day+ field trips)

REGISTRATION FEE: $180 (includes and Bible and field trips and supplies needed)

Students registered after 5/28 is NOT guaranteed a Tshirt.

FINANCIAL ASSISTANCE: We are part of the Child Care Payment Program (CCPP) and accept certificates. Parents who work at least 25 hrs per week (or in college) and children receive Medicaid, SNAP benefits, or qualify for free or reduced school lunches could qualify. Foster children or military children may also be eligible. The amount of financial assistance depends on family size, household income and other factors. Click here to learn more about CCPP and eligibility or call 800-877-7882

AGES: 5-12 HOURS: 7:30-6 pm (After school Hours are 3pm-6pm)

We provide childcare for ages 5-12, K-6th grades. Our students will be LEARNING during the summer! Our activities include Bible lessons, music lessons including guitar (3rd grade and up) or piano (1st grade and up), Skating weekly (parents need to furnish the skates), Karate (Gi is not required to purchase), Laser Tag, Arts and crafts, and VBS songs.

FIELD TRIPS include Country Lanes Bowling, Sawmill Theatre, Lauren Rogers Museum and First Baptist Church VBS. The cost of field trips are included in tuition rate.

MEALS: We serve a 9 am breakfast, 11:30 lunch, and a 2 pm and 4:30 snack. The cost of food is covered in the weekly tuition.

REGISTER: To reserve a spot, you will need to pre-register BELOW and pay your registration fee. The registration fee is non-refundable.

We will also need a copy of your child’s 121 Immunization Form and a booster seat if your child requires one by law.

Questions or want to schedule a tour or discuss financial aid? Email to Beth@fishersofmencenters.org to make an appointment.

ADDRESS: West Laurel Baptist Church 1400 W 5th Street Laurel MS (behind Walgreens across from Regions Bank)

Download our summer flyer here.

View our Tshirt Design here.

Group of diverse young students standing together in classroom

Student Pre-Register Application

Student Information. (An Application is required per student.)

If you are enrolling more than one student, you will need to pre-register them individually.

I am pre-registering because *

Student's Full Name *

First

Middle

Last

Date of Birth *

What age will the student be as of June 1, 2024? *

Sex *

Select Grade for 2024-2025 school year: *

Name of School *

Tuition Assistance maybe available for parents who meet the income and work requirements for participation in the Child Care Payment Program (CCPP). Have you applied for CCPP? *

CCPP Eligibility Guidelines can be found here: https://www.mdhs.ms.gov/eccd/parent-information/eligibility-guidelines/

What language is spoken by you and your family most of the time at home?

Was your child born in the United States? *

Parent/Guardian Information

Father/Guardian Name *

First

Last

Father's /Guardian Email

Father's/Guardian Cell Phone

Father's/Guardian Place of Employment

Mother/Guardian Name *

First

Last

Mother's /Guardian Email *

Mother's/Guardian Cell Phone *

Mother's/Guardian Place of Employment

Main/Home Phone

Address where student lives *

Address Line 1

Address Line 2

City

State

Zip Code

List any special needs your child may have. *

Does your child have any allergies? Please list, including food, if necessary *

Medical Concerns *

We do not administer medicine. The child will need to have their medicine before they arrive that day.

The center may obtain emergency medical treatment for my child if needed *

Behavior at School- Select One *

Please list Home Church and Pastor's Name.

Transportation: I give my approval for Fishers of Men Bible and Music Center to provide transportation for my child including after school pickup and field trips by a licensed driver in a vehicle owned by Fishers of Men. *

Field Trips: I understand my child maybe traveling on field trips and special activities throughout the enrollment period. *

Field trips will be announced on our monthly calendar and parents will be informed on additional cost.

Skating Consent: I understand that my child will be skating in the gym and waive any claim or cause of action and release liability of Fishers of Men and West Laurel Baptist Church for injuries to my child. I also agree to indemify and hold harmless. *

1. Waive any claim or cause of action against and release from liability the Fishers of Men Bible and Music Centers as well as West Laurel Baptist Church, its officers, board members, employees, and agents for any liability for injuries to my person, my child(ren) or property resulting from my child(ren) use of the facility or participation in the activity listed above; 2. Agree to indemnify and hold harmless the Fishers of Men Bible and Music Center as well as West Laurel Baptist Church, its officers, board members, employees, and agents for any claims, causes of action, or liability to any other person arising from my child(ren) use of the facility or participation in the activity listed above

Karate Consent: I understand that my child will be taking summer karate and waive any claim or cause of action and release liability of Fishers of Men and West Laurel Baptist Church for injuries to my child. I also agree to indemify and hold harmless. (copy) *

LAUREL SHOTOKAN KARATE CENTER 1. Waive any claim or cause of action against and release from liability the Fishers of Men Bible and Music Centers as well as West Laurel Baptist Church, its officers, board members, employees, and agents for any liability for injuries to my person, my child(ren) or property resulting from my child(ren) use of the facility or participation in the activity listed above; 2. Agree to indemnify and hold harmless the Fishers of Men Bible and Music Center as well as West Laurel Baptist Church, its officers, board members, employees, and agents for any claims, causes of action, or liability to any other person arising from my child(ren) use of the facility or participation in the activity listed above

Child's Tshirt Size (worn on field trips, recital and other events) *

A T-shirt is covered in your registration fee. Additional T-shirts maybe purchased for $12 each.

My child maybe photographed at the childcare center? *

We are a non profit and need public exposure as well as public donations to cover music lessons and instruments.

Media Release: My child's picture maybe used in media, newspapers, Facebook, etc. *

We are a non profit and need public exposure as well as public donations to cover music lessons and instruments.

How did you find out about our program? *

Emergency Contacts

In case of an emergency and the parents/guardian cannot be reached, please contact:

Emergency Contact # 1-Name *

First

Last

Phone *

Relationship *

Emergency Contact # 2-Name *

First

Last

Phone *

Relationship *

Emergency Contact # 3-Name *

First

Last

Phone *

Relationship *

Pickup- Drop-off List

The following people are authorized to pick-up and drop-off my child

Pickup/Dropoff -Name#1 *

First

Last

Pickup/Dropoff -Name#2

First

Last

Pickup/Dropoff -Name#3

First

Last

Pickup/Dropoff -Name#4

First

Last

Electronic Signature to this Application *

I agree, and give my consent
I do not agree

I, agree and understand that by signing the Electronic Signature Acknowledgment and Consent Form, that all electronic signatures are the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement.

Applicant Name and Date *

Please type your name in this box as your signature

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