Creative Preschool Registration Form

 

To Parents or Guardians:

Please fill in this form and return to the Preschool along with the $15.00 registration fee. 

 

Child’s Name:___________________________________________________

 

Class Preference: 

Morning Classes:  M/W 3 Yr. Olds_____  Tu/Th 4 Yr. Olds_____ 

Afternoon Classes: M/W Pre-K_____  Tu/Th Pre-K_____  4 Day Pre-K_____

 

Previously Attended Preschool:  Yes_____No_____  Where:­­­­______________

 

Birthdate_____________________                 Sex:  Male_____  Female_____

 

Home Address:__________________________________________________

_______________________________________________________________

 

Home Phone___________________    Cell Phone(s)____________________

 

Parents:  Married_____   Divorced_____   Other_____    

Deceased:  Mother_____   Father_____

 

Parents/Guardian with whom child is living:

           Name                     Relationship to child               Occupation           Phone

_______________________________________________________________

_______________________________________________________________

 

Other Siblings:

Name                                Sex                Birthdate                Live at home?

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

 

 

 

 

 

Special Health Concerns:___________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

 

Allergies:_______________________________________________________

_______________________________________________________________

 

Interests and Hobbies:_____________________________________________

_______________________________________________________________

 

Attends Church at:________________________________________________

 

__________________________

Parent Signature

 

What I would like my child to gain from this Preschool Experience:_________

_______________________________________________________________

_______________________________________________________________

 

I will_______will not_________ need transportation to and/or from preschool.