AMP 2025-2026 Student Registration
Student Name
*
First Name
Last Name
*
Male
Female
DOB
*
/
Month
/
Day
Year
Date
Parent/Guardian
*
First Name
Last Name
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Parent/Guardian Email
*
example@example.com
Is your child fully potty trained?
*
Yes
No
Are you interested in stay & play from 2-4pm
*
Yes
No
Program/Classes
*
Please Select
18-23 month M/W (Waitlist)
18-23 month T/TH (Waitlist)
18-23 month M-TH (Waitlist)
2 year old M/W (Waitlist)
2 year old T/TH (Waitlist)
2 year old M-TH (Waitlist)
3 year old M/W
3 year old T/TH (Waitlist)
3 year old M-TH (Waitlist)
3 year old M-F (Waitlist)
4 year old M/W (Waitlist)
4 year old T/TH
4 year old M-TH (Waitlist)
4 year old M-F (Waitlist)
Select the program based on your child's age as of September 1st.
List any allergies: (if they do not have any, type NONE)
*
If your child has an epi pen or uses an inhaler, please list that with the allergy.
If your child is 4+ years old, have they had a vision and hearing screening by their pediatrician?
*
Please Select
Yes, both
No, both
Yes, Vision Only
Yes, Hearing Only
My child is under 4 years old
We love sharing the fun we have at school! Do we have your permission to photograph your child and share it on Class Dojo and our school Facebook page?
*
Please Select
Yes
No
Yes, but only on the Class Dojo app
Individuals authorized to pick up your child:
Please complete the information below for anyone other than the parents/guardians that are authorized to pick up your child. We MUST have their NAME, PHONE # and ADDRESS.
Authorized Pick up #1
First Name
Last Name
Authorized Pick up #1 Phone Number
Please enter a valid phone number.
Authorized Pick up #1 Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Authorized Pick up #2
First Name
Last Name
Authorized Pick up #2 Phone Number
Please enter a valid phone number.
Authorized Pick Up #2 Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Reminder:
To save your spot you must complete this form AND drop off a check or money order for the registration fee ($110, non refundable, made out to FMC).
Submit
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