Davis Memorial Christian Church Preschool
2026 - 2027 School Year Registration Form
Tuition Fee
$125.00 per month
Child's Name
*
First Name
Middle Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Area Code and Number
Birthday
*
Current Age
*
Gender
*
Male
Female
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Mother's Name
*
First and Last
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Employment
Employment Phone
Father's Name
*
First and Last
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Employment
Employment Phone
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Next
Emergency Contact
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Back
Next
Physician to call if child becomes ill or injured:
Name
*
Hospital or Clinic
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
How did you find us?
Facebook
Newspaper
Radio
Other
Signature
*
Submit
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