St. Peter Lutheran Nursery School Registration Form
Information needed to complete this form: Parents' contact information including employment details, at least 2 emergency contacts along with their phone #s and addresses, and up to 2 additional authorized pick-up persons if desired. You will also need to list your child's doctor, address, and phone #.
Child's last name *
Your answer
Child's first name *
Your answer
Name child goes by
Your answer
Date of birth *
MM
/
DD
/
YYYY
Gender
Street address *
Your answer
City *
Your answer
State *
Your answer
Zip code *
Your answer
Landline phone # (if applicable)
Your answer
Next
Never submit passwords through Google Forms.
This form was created inside of Margaret Margaret. Report Abuse