Preschool Registration

Cedros Gems Preschool Registration Form

Touching lives Forever
Upon Registration please attach; a form of parent(s) I.D, a copy of birth certificate, a passport size photo and immunization record
Expected Start Date

MonthDayYear
Student Information
First Name
Last Name
Gender
Birth Date

MonthDayYear
Current Age
Home Phone

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Information 1
Full Name

First NameLast Name
Home

Area CodePhone Number
Cell

Area CodePhone Number
Work

Area CodePhone Number
E-mail
Address - Same As Child
If your address is different than the childs please fill out the info below. Otherwise move onto the next section.
Parent/Guardian 1 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Information 2
Full Name

First NameLast Name
Home

Area CodePhone Number
Cell

Area CodePhone Number
Work

Area CodePhone Number
E-mail
Address - Same As Childs
If your address is different than the childs please fill out the info below. Otherwise move onto the next section.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Other Infomation
Is your child immunized?
Does your child have any allergies?
If yes please list, including any food or drug allergies.
Does your child have any medical conditions?
Does your child require any medication? If yes, please list these medications.
Do you authorize us to administer the medications listed above?
Please list the people authorized to pick up your child.
Photos are usually taken during class activities and are reused in our Whatsapp group chat at times. Please state if you give authorization for your child(ren)'s photo to be used.
Comments
Emergency Contact - Other than Parent/Guardian
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home

Area CodePhone Number
Cell

Area CodePhone Number
Work

Area CodePhone Number
Thank you for choosing Cedros Gems Preschool! We assure you this is the best choice you can make towards your child's future. We looking forward to working with you.
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Cedros Gems Preschool Registration Form

Upon Registration please attach; a form of parent(s) I.D, a copy of birth certificate, a passport size photo and immunization record

Student Information

Parent/Guardian Information 1

Parent/Guardian Information 2

Other Infomation

Emergency Contact - Other than Parent/Guardian