Student Registration

Student Registration

2024-2025 School Year
Section 1:

Student Information
Student's Legal Name:*

First NameLast Name
What name do you call this child at home?
Sex

MaleFemale
Birth Date*

MonthDayYear
Date
Child's Address*
Is your child allergic to any foods?

YesNo
If yes, what food(s)?
Does your child have any dietary restrictions?

YesNo
If yes, what restriction(s)?
Does your child have any medical conditions that require him/her to have specialized treatment?

YesNo
If yes, what condition(s)?
Is your child able to use the toilet independently?

YesNo
Is there any information that you would like your child's teacher to know?
Section 2:

Family Information
Parent or Legal Guardian 1

First NameLast Name
Email Address
Primary Phone Number

Area CodePhone Number
Secondary Phone Number

Area CodePhone Number
Parent or Legal Guardian 2

First NameLast Name
Email Address
Primary Phone Number

Area CodePhone Number
Secondary Phone Number

Area CodePhone Number

Who lives in the same house as the student?

In addition to the Parents/Guardians, who is authorized to pick up your child from school?

Section 3:

Videos or Photographs of your child may be taken during class. We will never publish or post a photo or video of your child without your written permission. Please let us know your preferences for your child's photos and videos.
Do you give permission for your child’s photo or video to be posted on the Preschool's website?

YesNo
Do you give permission for your child’s photo or video to be posted on the Preschool's Facebook private page?

YesNo
Do you give permission for your child’s photo or video to be used in written advertisements (pamphlets/flyers) for the school?

YesNo
Class Selection

Available class times are subject to change based on enrollment. Please choose one from the drop-down menu. We will contact you to confirm enrollment and receive registration payment.
Morning Classes for 3-year-olds, 9:00-11:30am:
Morning Classes for 4-year-olds, 9:00-11:30am:
Afternoon Classes for 4-year-olds, 12:30-3:00pm:
All-Day Classes for 4-year-olds, 9:00am-3:00pm:
Signature
Today's Date

MonthDayYear
Date
Should be Empty:

Section 1: