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Preschool Registration SY 21-22
Preschool class size is limited to 20. Registration fills very quickly. Please submit this form ASAP
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* Indicates required question
Email
*
Your email
Child's First Name
*
Your answer
Child's Last Name
Your answer
Gender
Female
Male
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Date of Birth (Must by Three by 10/1/19)
*
MM
/
DD
/
YYYY
Home Address
*
Your answer
City
Your answer
State
Your answer
Zip code
Your answer
Parent 1 Name
Your answer
Parent 2 Name
Your answer
Home Phone Number
*
Your answer
Cell Phone Number
Your answer
Does your child have medical concerns or learning issues that we should be aware of?
Your answer
Does your child have allergies? and if so to what?
*
Your answer
Siblings? Age, Gender, School?
Your answer
How did you hear about the program?
Your answer
Why are you interested in enrolling your child in this program?
Your answer
What are your child's favorite toys? or things to play with?
Your answer
What other organized activities is your child involved in (soccer, gymnastics, preschool, etc)?
Your answer
Has your child had opportunities to play/interact with other children? (library groups, play dates) Do they play well with other children?
Your answer
Do you have a preference for session? (AM preferably for 3's PM preferably for 4's)
*
AM Session 8:55 am 10:40 am
PM Session 11:30- 1:55 pm
either session
A copy of your responses will be emailed to the address you provided.
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