Preschool Registration Form printable pdf download

STONERIDGE PRESCHOOL REGISTRATION FORM

Date:_____________________, 20______

Name of Child:__________________________________

Nickname:_______________________

Email Address: _____________________________________________

Address:___________________________________________________________________________

Date of Birth:________________________ Home Phone Number:___________________________

___________ 2-Day program (3 year old)

___________ 3-Day program (4/5 year old)

Father:_______________________________ Occupation:__________________________________

Business/Cell Phone:_____________________________

Mother:_______________________________ Occupation:__________________________________

Business/Cell Phone:_____________________________

If Parents are employed, who cares for child?______________________________________________

Address:_________________________________ Phone Contact:_____________________________

Name and ages of brothers and sisters:___________________________________________________

_________________________________________________________________________________

Church Affiliation:___________________________________________________________________

Has this child attended a preschool previously? _________________________

Details (where, when, etc.)_____________________________________________________________

In case of emergency contact:

Name:____________________________________ Telephone:_______________________________

The following people have permission to pick up and transport my child:

Name:____________________________________ Telephone:_______________________________

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This form and a registration fee of $35.00 should be returned to:

Stoneridge Preschool 811 Dressel Road Allison Park, PA 15101 Phone: 412-486-7778

This registration fee is non-refundable. It includes administrative costs, insurance, and holds your

child's place in class. Checks should be made payable to: STONERIDGE PRESCHOOL.

Preschool Registration Form