Pre-Registration Form for Children Ages 6 Weeks to 6 Years

Pre-Registration Form for Children Ages 6 Weeks to 6 Years
Welcome to Milestones Academy of Texas!

Important: Only the child's parent or legal guardian may complete this form.
Thank you for taking the time to complete this pre-registration form. This form helps us gather contact information of the prospective families interested in enrolling their children.

If you have any questions, please email us at registration@milestonesacademytx.com.
Parent/Guardian Information
Parent/Guardian Completing Form*

First NameLast Name
Parent/Guardian Cell Phone Number*
Format: (000) 000-0000.
Parent/Guardian Email*
MotherFatherLegal GuardianOther
Child's Father's Name*

First NameLast Name
Child's Mother's Name*

First NameLast Name
Child's Mother's Name*

First NameLast Name
Child's Father's Name*

First NameLast Name
123
Child's Name*

First NameLast Name
Child's Date of Birth*

MonthDayYear
If expecting, enter estimated due date
MaleFemale
Please Indicate Preferred Start Date:*

MonthDayYear
Child's Name*

First NameLast Name
Child's Date of Birth*

MonthDayYear
If expecting, enter estimated due date
MaleFemale
Please Indicate Preferred Start Date:*

MonthDayYear
Child's Name*

First NameLast Name
Child's Date of Birth*

MonthDayYear
If expecting, enter estimated due date
MaleFemale
Please Indicate Preferred Start Date:*

MonthDayYear
Should be Empty:

Welcome to Milestones Academy of Texas!