Ardmore Christ Community Church Mother's Day Out Registration 2018-2019
Parent(s) Name *
Child's Legal Guardian(s)
Your answer
Phone Number *
Primary Contact Number
Your answer
Text Notifications
If you would like to receive updates and announcements (school closures, tuition reminders, etc.) via text message, please list the mobile service provider for your primary contact number.
Your answer
Email Address *
This address will be used to communicate important information and announcements. Please provide an email account you check often.
Your answer
Mailing Address *
Please include city and zipcode.
Your answer
Child's Name, Gender, and Birthdate *
Please write the full name and details for each child that you would like to enroll.
Your answer
Potty Training
If your child will be 3 years old by the start of session, please confirm that they are independently using the potty.
Special Concerns
Please share any known allergies, health conditions, physical limitations, developmental issues, or special considerations for your child.
Your answer
Emergency Contact *
Please provide the name, phone number, and relationship of the person to contact if a parent is not available at the number listed above.
Your answer
Authorized Pickup
Please list the names and relation of those who have permission to pick up your child(ren) from MDO.
Your answer
Additional Notes
You may offer any other information you believe would be helpful for the teachers to know about your child's family, personality, behavior, fears, or needs. We want to give your children the best care possible!
Your answer
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