Community Preschool Registration Form Page 2

Jack

Jill

Community Preschool

Registration Form

**This portion will go to the Teacher**

Child’s Name: ____________________ Nickname: __________________

Date of Birth: _________________

Emergency Contact Information:

Parent (s):_________________________________

Phone:_________________________

*If the parent (s) are unable to be reached, call:

_____________________________________________________

1.)

_____________________________________________________

2.)

Child’s Doctor:_____________________________

Phone:_________________

Allergies and/or pertinent medical information:

_____________________________________________________________

Are there any specific problems the teacher should be aware of?

_____________________________________________________________

0 votes

Parent category: Life