2024 LIFE Preschool Registration

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Please bring a copy of your child's birth certificate if this is your child's first year at LIFE Preschool. You can also email it to preschool@beulahchurch.org.
Immunization records can be faxed to 574-875-6538.

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Child's first name: *

Child's Last Name: *

What version of your child's name would you like them them to practice writing and have printed on their schoolbag and pick-up tags? (For example Eleanor or Ellie, Leo or Leonardo?) *

My child is a *

boy.

girl.

He/She was born on *

YYYY

Home address *

City *

State *

Zip Code *

Home phone number *

Email address is *

Parent/Guardian Name *

Cell Phone Number *

Occupation

Work Phone Number *

Parent/Guardian *

Cell Phone Number *

Occupation

Work Phone Number *

繼續

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