Ics After School Daycare - Family Registration Form
ADVERTISEMENT
1
2
3ICS
A fter
S chool
D aycare
–
F amily
R egistration
F orm
Please
c omplete
o ne
f orm
( 3
p ages)
p er
f amily.
Child(ren)
Children
Name(s)
Grade(s)
2 015-‐16
Birth
D ate(s)
( dd/mm/yy)
Child
# 1
Child
# 2
Child
# 3
Child(ren)’s
H ome
A ddress:
Home
T elephone:
Parent/Guardian
# 1
Parent/Guardian
N ame:
Email:
Cell
N umber:
Home
A ddress
( if
d ifferent
t han
a bove):
Work
A ddress:
Home
T elephone
Work
T elephone:
(if
d ifferent
t han
a bove):
Parent/Guardian
# 2
Parent/Guardian
N ame:
Email:
Cell
N umber:
Home
A ddress
( if
d ifferent
t han
a bove):
Work
A ddress:
Home
T elephone
Work
T elephone:
(if
d ifferent
t han
a bove):
Emergency
C ontact
Contact
N ame:
Email:
Cell
N umber:
Home
A ddress:
Work
A ddress:
Home
T elephone:
Work
T elephone:
Relationship
t o
C hild(ren)
( e.g.,
n anny,
p aternal
g randparent,
f amily
f riend):
Page
1
o f
3
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Education