Preschool Student Registrations
Please complete the following information for your
Preschool Student
. You will be redirected to the next form to complete the Parent info and pay the family registration fee. Your registration is not complete unless BOTH sections are completed.
*
Child
First Name
*
Child
Last Name
*
Child
Birth Date
*
Child
Gender
Female
Male
Child
Allergies
EPI PEN NEEDED
No Known Allergies
Amoxicillin
Bee Stings
Blueberries
Cefprozil
Cephalexin
Chocolate
Cinnamon
Coconut
Dairy
Dust
Eggs
Fish
Flax Seed
Food Dyes
Fruits and vegetables
Gluten
Honey
Insect stings
Latex
Meat
Milk
Mold
Mustard
Peas/Chick Peas
Peanuts
Penicillin
Pollen
Seeds
Sesame
Shellfish
Soy
Strawberries
Tomato Sauce
Tree nuts
Wheat
Oats
Wheat-Celiac Disease
* PreK Class Choice
Select one
3 Year Old T/TH [No longer available]
3 Year Old M/W/F [No longer available]
4 Year Old M/W/F [No longer available]
4 Year Old Mon - Thur [No longer available]
5 Year Old Mon - Fri [No longer available]
WAITLIST - 3 Year Old T/TH
WAITLIST - 3 Year Old M/W/F
WAITLIST - 4 Year Old M/W/F
WAITLIST - 4 Year Old Mon - Thur
* I consent that my child's photo may be used for promotions.
Select one
Yes
No
* My Information may be released for a class contact list
Select one
Yes
No
* Parent / Guardian Name
* Parent/Guardian Email
Add Another Child
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