Lucky Ducks Preschool Registration 2021/2022
Please fill out this form to register your child for Lucky Ducks Preschool!
Contact Ranell Williamson with any questions!
luckyduckspreschool@gmail.com
971-223-3884
What is your child's first name? *
What is your child's last name? *
Gender *
What name do you want your child to learn to write -- if different from above? (For example a nickname)
Is your child left handed or right handed? *
Birthday *
MM
/
DD
/
YYYY
Age on September 14th, 2021 *
Please list any allergies and/or other health concerns *
Address where child lives *
Parent/Guardian Name -- both parents or main Guardian *
Parent/Guardian Cell -- both parents or main Guardian *
Parent/Guardian Email Address -- please list anyone to whom preschool emails should be sent *
Whom does child live with? (Mom, Dad, both parents, split custody, other guardian? Please list any siblings and ages)
Minimum enrollment of 3 days is required. Choose the 3 day or 4 day option: *
Required
Do you want to add the optional Lunch Bunch? (Bring lunch from home and stay an extra hour from 12-1pm) Additional fee per month is $45 (3 days) or $60 (4 days). *
How did you hear about our preschool? *
An optional fee of $25 is offered for a handmade Memory Binder with photos & art projects that we collect throughout the year. The teachers put this together for you and it will be delivered at the end of the year. If you would like one, please answer yes and this fee will be added to your Materials Fee. *
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