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Preschool Readiness Activity Group Registration
Arlington Street Community Center
36 Arlington Street, Nashua, NH 03060
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Email
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Your email
Guardian's Name
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Guardian phone number
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Emergency Contact name and phone number
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Your answer
Adults names allowed for Pick-up and contact information
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Child's Name
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Your answer
Child's Birth-date
MM
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DD
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Child's Age as of January 1, 2023
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Your answer
Is this child potty-trained?
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Yes
No
Other:
Does your child have any special needs that our teachers should be aware of? Can include a history of seizures, hearing or sight difficulty, sensory processing differences, etc.
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Please list any allergies your child has.
*Note: if your child's allergy requires an epi-pen, the child is required to bring this every time they attend the program!
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What languages are spoken at home?
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What is your child's favorite type of play? (dancing, playing with dolls, sensory play, etc)
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What are some things that might make your child upset in a new setting?
Your answer
What are some stress/ coping techniques that you've found to be useful with your child?
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Is there anything currently going on or has happened to cause your child stress? (death of a loved one, food insecurity, new sibling on the way, etc...)
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What else should we be aware of?
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Do you consent to having unidentifiable photos taken of your child and potentially posted on our ASCC website or social media page? (unidentifiable photos can include photos that do not show your child's face and never mentioning first or last names of children. You would be notified and shown the photo before it would be used.)
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Yes
No
Other:
Would you like to also sign-up for the Waterford Upstart?
Waterford Upstart is a completely free online program that ensures your child is ready for Kindergarten. Made for 4 and 5 year olds, this program provides learning through play for as little as 15 minutes a day.
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