Preschool Registration Form
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How did you hear about OUMC Preschool/Pre-K *
Enrollment *
Child's First Name *
Child's Last Name
Name to be used in school *
Sex *
Date of Birth *
Child's Age *
Does your child have any allergies *
Writing Hand *
Address *
Best Phone Contact *
Mother's First Name *
Mother's Last Name
Mother's Cell Phone *
Mother-TEXT? *
Mother's E-mail Address *
Mother's Address *
Mother's Employer *
Mother's Occupation *
Mother's Work Phone *
Father's First Name *
Father's Last Name
Father's Cell Phone *
Father-TEXT? *
Father's E-mail Address *
Father's Address *
Father's Employer *
Father's Occupation *
Father's Work Phone
Marital Status of Parents *
Other Children in the Family (Name and Age) *
Daycare *
Daycare Phone *
Daycare Address *
Contacts if Parents cannot be reached *
Has your child previously attended Preschool? *
Does your child have experience playing with other children? *
What activities does your child enjoy outdoors? *
What activities does your child enjoy indoors? *
How does your child react to new situations? *
What problems do you experience most frequently with your child? *
What would you like your child to acquire through Preschool/Pre-K? *
Other information we need to know about *
Authorized Pick Up List *
Not allowed to pick up *
Doctor Name *
Doctor Phone *
Hospital Reference *
Does your child have any health problems? *
Does your child have any unusual habits, problems, or fears? *
Has your child ever been hospitalized or had surgery? *
Date of most recent Physical exam *
Does your child have any dietary restrictions, allergies, etc? *
Please list any medications your child takes daily *
Picture Permission *
Public picture permission (Church Facebook, advertising) *
Private picture permission (Private class only Facebook, Remind, other preschool families) *
Walking Field Trip *
Riding Field Trip Permission *
Evaluation Permission *
Evaluation Shared Permission *
Signature *
Date *
Submit
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