ST. ALBAN'S 2015/2016
Preschool Registration Form
CHILD'S NAME: _______________________________________ Date of Birth:_______________
ADDRESS: ______________________________________________________ Zip:______________
TELEPHONE: _________________________ CELL
MOTHER'S NAME: ________________________ FATHER’S NAME:______________________
E-MAIL ADDRESS: ________________________________________________
My child will attend the following program:
Preschool class only- 9:00am-12:00pm ________
Full Day_______6 hours including preschool hours 9:00-12:00
Extended Day________ 6 + hours (7am-6pm)
I prefer my child to attend school on the following days:
Monday_______ Tuesday__________ Wednesday__________ Thursday__________ Friday_____________
My full or extended day student will take a nap at school. Yes
Fees required at registration:
___ $50.00 continuing students
__ $75.00 new students
The information, on this form, except date of birth, will be used in the directory. Please initial here if
you wish to be included in the directory.
I give permission to St. Alban's personnel to apply sunscreen/ bug spray (provided by parents) on
my child. ______________________
I give permission for my child to be photographed for use on school boards, class blogs, and
classroom portfolios. ____________________________
I give my child permission to attend Chapel in the chapel. ___________________________________.
I give my child permission to go to rooms 11/12 for activities. ________________________________.
I give permission for St. Alban’s staff to use Kirkland Wipes on my child.________________________.