Author: Preschool

STUDENT I.D.

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St. Paul’s Preschool
Pre-K 2023-2024 Registration
Child’s Name ______________________________ DOB ____________________
Child’s Nickname or name used: ___________________________________________
Child lives with: Parents Mother Father Other _____________
Address _____________________________________ City, Zip _________________
Home phone __________________ Email ___________________________________
Mother’s Name _______________________ Cell Ph # _____________________
Occupation __________________________ Phone # ______________________
Father’s Name ________________________ Cell Ph # _____________________
Occupation ___________________________ Phone #______________________
Child Care Provider ____________________ Phone # ______________________
List 2 emergency contact numbers in the order in which we should call them.
Parents will be called first; these are back-up emergency numbers.
Name _______________________ ___ Phone # _____________________
Name ___________________________ Phone # _____________________
Is there any allergies or medical conditions that we should know about your child? ____________________________________________________________________
____________________________________________________________________
What would you like your child to get from his/her preschool experience? ____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Do you have a church home? ____________________________________________
If not, may we contact you? _____________________________________________
A $75.00 non-refundable registration fee is due upon enrollment.
We cannot hold a spot for your child without receiving their registration fee.
$75.00 Registration Fee □ Check #________ □ Cash receipt #__________ Date Received________

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