24/25 Baltic School District Preschool Pre-Registration

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Please fill out the following information for your preschool aged student. They will need to be three years old on or before September 1, 2024 to be eligible for Baltic's Preschool. Please note this is "Pre-Registration". You will still need to complete the Online District Registration once it opens during the summer of 2024.

Child's First Name *

Child's Last Name *

Child's Date of Birth *

YYYY

Child's Gender

Male

Female

Clear selection

Child resides

in the Baltic School District

outside of the Baltic School District

Unsure

Clear selection

Preference ( This is NOT a guarantee, but we will accommodate as best we can.) *

Morning Session (8:20 - 11:20, Mon-Thurs)

Afternoon Session (12:15 - 3:15, Mon- Thurs)

No Preference (Mon-Thurs)

Transportation: *

I will provide transportation for my child both to and from preschool.

I would like my child to ride the regular district school bus: to the morning session OR home from the afternoon session.

I would like mid-day transportation provided (for a fee) either to OR from an in-town daycare.

Required

For middle of the day transportation my child would need to be picked up OR dropped off at the following in-town daycare (provide name & address):

Parent/Guardian #1 First and Last Name: *

Parent/Guardian #1 relationship to child: *

Parent/Guardian #1 Physical Address: *

Parent/Guardian #1 Mailing Address (if different than physical):

Parent/Guardian #1 Cell Phone: *

Parent/Guardian #1 Email: *

Parent/Guardian #2 First and Last Name:

Parent/Guardian #2 relationship to child:

Parent/Guardian #2 Physical Address:

Parent/Guardian #2 Mailing Address (if different than physical):

Parent/Guardian #2 Cell Phone:

Parent/Guardian #2 Email:

Emergency Contact #1 First and Last Name: *

Please provide 2 emergency contacts that you give permission to pick up your child and or notify if parent/guardian cannot be reached.

Emergency Contact #1 Address: *

Emergency Contact #1 Phone Number: *

Emergency Contact #1 Relationship: *

Emergency Contact #2 First and Last Name:

Emergency Contact #2 Address:

Emergency Contact #2 Phone Number:

Emergency Contact #2 Relationship:

What has your child's daytime experience been up to this point:

Childcare center

In-home daycare

Home with caregiver

Other:

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