Preschool Application 2026–2027
Please complete this application to register your child for the 2026–2027 school year at Love One Another Preschool.
Child's Name (First, Middle, Last, Nickname)
*
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Please Select
Male
Female
Home Address - Street
*
Home Address - City
*
Home Address - State
*
Home Address - Zip Code
*
Home Phone #
*
Please enter a valid phone number.
Format: (000) 000-0000.
Child Lives With
*
Both Parents
Mom
Dad
Guardian
Parents Are
*
Married
Never married
Divorced—Custody Documents on file: Y
Divorced—Custody Documents on file: N
Parent 1/Guardian Name
*
Parent 1 Home Address
*
Parent 1 Home Phone #
Please enter a valid phone number.
Format: (000) 000-0000.
Parent 1 Cell #
Please enter a valid phone number.
Format: (000) 000-0000.
Parent 1 Email Address
example@example.com
Parent 1 Occupation
Parent 2/Guardian Name
Parent 2 Home Address
Parent 2 Home Phone #
Please enter a valid phone number.
Format: (000) 000-0000.
Parent 2 Cell #
Please enter a valid phone number.
Format: (000) 000-0000.
Parent 2 Email Address
example@example.com
Parent 2 Occupation
Do you have a church home?
Yes
No
If yes, name of church
Other schools your child has attended
Are monthly finances a hardship?
Yes
No
How did you learn of our school?
Emergency Contact Name
*
Emergency Contact Relationship
*
Emergency Contact Address
*
Emergency Contact Phone No.
*
Please enter a valid phone number.
Format: (000) 000-0000.
Authorized Pickup Person 1 - Name
Authorized Pickup Person 1 - Phone No.
Please enter a valid phone number.
Format: (000) 000-0000.
Authorized Pickup Person 2 - Name
Authorized Pickup Person 2 - Phone No.
Please enter a valid phone number.
Format: (000) 000-0000.
Authorized Pickup Person 3 - Name
Authorized Pickup Person 3 - Phone No.
Please enter a valid phone number.
Format: (000) 000-0000.
Child’s Special Care Needs (check all that apply)
Asthma
Diabetes
Seizures
ADD/ADHD
Other
Other special care needs (specify)
Explain any needs selected above in Special Care Needs/Allergies
Does your child have food allergies?
Yes
No
Food allergy Emergency plan submitted on Date
-
Month
-
Day
Year
Date
Consent for Emergency Medical Care - Child’s Name
*
Consent for Emergency Medical Care - Parent/Guardian Signature
*
Consent for Emergency Medical Care - Date Signed
*
-
Month
-
Day
Year
Date
Website and Social Media Release - Parent/Guardian Name
Website and Social Media Release - Child’s Name
Website and Social Media Release - Parent/Guardian Name (Printed)
Website and Social Media Release - Parent/Guardian Signature
Child's Health - General state of health
Doctor’s name
Doctor’s Phone number
Please enter a valid phone number.
Format: (000) 000-0000.
Are your child's immunizations up to date?
Yes
No
Does your child have any known allergies?
Are you concerned that your child may be prone to any type of allergies?
Yes
No
Describe allergy concerns
Does your child have any medical conditions which I should be made aware of?
Has your child had the following common childhood illnesses?
Chickenpox
Measles
Mumps
Rubella
Other
Does your child have any speech, hearing or visual problems?
Would there be any restrictions to play or activities?
Parent Signature (verification of information)
*
Parent Signature Date
*
-
Month
-
Day
Year
Date
Parent Name (Printed)
*
Submit Application
Submit Application
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