GBC Grace Kids Pre K Registration

Pre- K (3-4 yrs old) Child Registration Form

Childs Name

Age

DOB

ParentGuardian

Email contact

example@example.com

Primary phone number (to contact during service)

Secondary phone number

Allergies/ Special Requirements:

As a part of our regular schedule, we will have a snack time for the children. We will serve plain Cheerios. May your child have this?

Can your child drink out of a small dixie cup?

*If your child cannot have the provided snacks due to allergies, we ask that you bring a snack for your child and give it to the teacher before class starts.

Please Check all that apply:

My child is potty trainingMay child is fully potty trainedYou may assist my child in the bathroom with clothing and/or wipingMy child is able to manage in the bathroom without assistanceYou MAY NOT assist my child in the bathroom- call me to take my child to the bathroom

* In the case of an accident, we will contact you to take care of your child.

Is there anything in particular we should know about your child that you believe might help us to care well for them?

Only these two additional people may pick up my child from the nursery.

NAME

Relationship to child

NAME

Relationship to child

Parent Signature

Date