Kindergarten Registration
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Students Name:
Birthday:
MM
/
DD
/
YYYY
Mailing Address:
Home Address:
Mother's Name:
Mother's Cell Phone:
Mother's Workplace & Phone:
Mother's Email:
Father's Name:
Father's Cell Phone:
Father's Workplace & Phone:
Father's Email:
Medical Concerns: (Allergies, Medication, etc.)
In case of emergency (when parents cannot be reached) call: (Please leave name, number, & relationship to student.) Contact One:
In case of emergency (when parents cannot be reached) call: (Please leave name, number, & relationship to student.) Contact Two:
How I Get to School
Clear selection
How I get home:
Clear selection
Any specific transportation information daycare name, bus number, etc.
Storm Information: In the event of a severe winter storm and school is let out early, please provide information of where your child is to go. There is NO ESP if school is let out early.
Any additional information that you would like me to know about your child:
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