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Panther Preschool Registration
Please fill out each section with your and your child's information.
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* Indicates required question
Email
*
Your email
Child's First Name
*
Your answer
Child's Last Name
*
Your answer
Does your child prefer to be called something else?
Your answer
Child's Birthdate
*
MM
/
DD
/
YYYY
Gender
*
Male
Female
Address
*
Your answer
Mother's First Name
*
Your answer
Mother's Last Name
*
Your answer
Mother's Cell Phone Number
*
Your answer
Is it okay to text this number?
*
Yes
No
Mother's Email Address
*
Your answer
Is it okay to send emails to this address?
*
Yes
No
Father's First Name
*
Your answer
Father's Last Name
*
Your answer
Father's Cell Phone Number
*
Your answer
Is it okay to text this number?
*
Yes
No
Father's Email Address
*
Your answer
Is it okay to send emails to this address?
*
Yes
No
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