School Registration

Emergency Contact 1
Name

First NameLast Name
Phone Number

Area CodePhone Number
Emergency Contact 2
Name

First NameLast Name
Phone Number

Area CodePhone Number
Medical Information or Allergies
Please list any of the following: Current medications, Medication allergies, Food allergies, Chronic health concerns.
Please inform Ms. Ali of any other vital information you think they may need to know in the event of an emergency.
How did you find out about our preschool?
Occasionally we will take pictures of our students to be used on our social media sites and website. Do you give your consent for us to post these?

yesnoOther
Liability Clause

I release the preschool from any liability associated with any activities my child will be involved in while attending. I also give permison for emergency transportation and medical treatment.
Signature

Clear
For licensing and insurance purposes, Creative Kids must collect a copy of your child's immunizations records. Please attach a photo of your child immunization records or an exemption form and attach it below. Also, please mark what type of form you will submit below.

immunization recordmedical, religous or personal exemption
Take Photo
Should be Empty:

Ms. Ali’s Creative Kids Preschool Registration