KIDS PALACE PRESCHOOL REGISTRATION FORM
Child’s Information
First Name: ____________________________ Last Name: ______________________________
Physical Home Address: __________________________________________________________
City: ________________________________________ Postal Code: ______________________
Birthday: _________________________________________
Male______
Female______
Parents or Guardians
First Name: ____________________________ Last Name: ______________________________
Relationship: _________________________ Email address: _____________________________
Physical Home Address: ________________________________________Box # ____________
City: _________________________________________ Postal Code: _____________________
Phone number: ___________________________ Cell number: ___________________________
Place of Work __________________________________________________________________
Physical Work Address: __________________________________________________________
City: _________________________________________ Postal Code: _____________________
Work Number: _____________________________
First Name: ____________________________ Last Name: ______________________________
Relationship: _________________________ Email address: _____________________________
Physical Home Address: __________________________________________________________
City: _________________________________________ Postal Code: _____________________
Phone number: ___________________________ Cell number: ___________________________
Place of Work: _________________________________________________________________
Physical Work Address: __________________________________________________________
City: _________________________________________ Postal Code: _____________________
Work Number: _____________________________