2017-2018 Preschool Registration Packet
Welcome to Kool Kidz Preschool! Registration must be completed before students may attend. Thank you and we look forward to having you child in class!
Email address *
Child's Name: *
Your answer
Child's Nickname/Goes by:
Your answer
Birthday and Age *
Your answer
Gender *
Home Address, City, State, Zip Code *
Your answer
Parent/Guardian Information
Name *
Your answer
Relationship to child *
Your answer
Home Address (if different from child's), City, State, Zip Code
Your answer
Phone Number (Home) *
Your answer
Phone Number (Cell)
Your answer
Phone Number (work)
Your answer
Email *
Your answer
Marital Status *
Who does the child live with *
Your answer
Second Parent or Guardian
Name
Your answer
Relationship to child
Your answer
Home Address (if different from child's), City, State, Zip Code
Your answer
Phone Number (Home)
Your answer
Phone Number (Cell)
Your answer
Phone Number (work)
Your answer
Email
Your answer
Emergency Contact Information (Adults other than those already listed above.)
Name *
Your answer
Relationship to child *
Your answer
Phone Number *
Your answer
Pick Up Authorizations
Please list the names of persons other than parents/guardians authorized to pick up your child.
Your answer
Security
Please describe any living arrangements, custody issues or court orders we should be aware of or would be helpful to the child's teacher
Your answer
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