Registration Form

Child's Name:

Date of Birth:

Gender:

Address:

Parent/Guardian Name:

Phone Number:

Email Address:

Additional Parent/Guardian name:

Name:

Relationship to Child:

Phone Number:

Allergies:

Medications:

Health conditions:

Do you prefer morning or afternoon session?

Is your child potty trained?

-What are some of your child’s favorite things?

-Are there any other needs we should be aware of?

- How did you hear about our preschool?

-Preferred form of payment? (Venmo, PayPal, Cash)