Chesterton United Methodist                        Preschool Registration     2025 - 2026
Sign in to Google to save your progress. Learn more
Email *
Child's Full Name *
What name do you call your child? *
Gender *
Full Address *
Home Phone number
Birthdate *
MM
/
DD
/
YYYY
Religious Background/Church you attend *
Mother's/Guardian Name: *
Mother's Address if different from the child
Mother's Email
Mother's Cell #
Father's/Guardian Name: *
Father's Address if different from the child
Father's Email
Father's Cell #
Marital Status *
Siblings - Names & Birthdates
I would like my child to attend: *
I prefer *
May we put your child's picture on our website/facebook page? *
Does your child have any medical issues (disabilities, allergies, etc.) that we should be aware of?  If so, please explain *
Does your child use the following at home? *
Required
What do you see as your child's strengths? *
Is there any area in which you anticipate difficulty for your child (sharing, following directions, etc.)? *
What other information would you like us to know about your child?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms