Preschool Waitlist
Please fill out our registration form for a spot on the wait list.
Personal Information
Child's Name *
Your answer
Gender *
Name child usually goes by (If different from above)
Your answer
Birth Date *
MM
/
DD
/
YYYY
Parent/Guardian Names *
Your answer
Home Address (street, city, postal code) *
Your answer
Home telephone number
Your answer
Parent 1 Cell Phone Number *
Your answer
Parent 2 Cell Phone Number *
Your answer
Email Address *
Your answer
Parent 1 Place of Work ( + work phone number) *
Your answer
Parent 2 Place of Work ( + work phone number) *
Your answer
Are there any special concerns about your child that you would like us to know?
Your answer
Authorization Information
Please provide the names of any persons who have the parent's authorization to remove the child from preschool (ie. child care, car pool, grandparent etc.)
Name, Address & Phone Number *
Your answer
Class Preference (Select all that apply) *
Required
Medical Conditions
Are your child's immunizations up to date? *
Does your child have any known food allergies? *
If yes, what are they?
Your answer
Please list any conditions (medical or other) that the Preschool should be aware of:
Your answer
Social Information
Religious Affiliation (if any) **Please note that FGCC Preschool is a Christian based Preschool *
Your answer
Names and ages of brothers and/or sisters: *
Your answer
Do both parents live with the child? *
To the best of my knowledge, all of the above information is correct. I will also inform my child's Preschool Teacher of any changes in the above information such as, telephone number, address, emergency number etc *
Permission to Release Contact Information
We require your permission to release your child's contact information, including the following:

Child's first and last name
Parent name(s)
Address
Home telephone number

If you consent to the release of the above contact information to the other parents in your child's preschool class, please select "yes" *
Permission for Medical Care
Our procedure in cases of emergency, such as sudden illness or serious accident is:
1) to render first aid
2) to contact the parent/guardian or, being unable to reach them, we will contact the other emergency contact indicated below.
In some cases, failure to establish contact could delay treatment. Only after all reasonable efforts have been made to contact you, will we call your doctor, and only in the most extreme cases will your child be taken to the hospital.
Please list any drug allergies *
Your answer
Other Emergency Contact (Name, Phone number, relationship to child) *
Your answer
Doctor's Name & Phone Number *
Your answer
Saskatchewan Personal Health Number *
Your answer
You have my permission to act accordingly *
Fee Schedule
Should a spot become available, you will be contacted to submit the following.

- A $50.00 non-refundable registration fee per child on a separate cheque is required
- One cheque dated September 1, 2019 paying two month's fees (September & May - $170)
- Seven cheques dated the first of the month from October 2019 - April 2020 for $85.00
- Please make cheques payable to Forest Grove Community Church or FGCC


PLEASE NOTE: Registrations will not be considered complete unless accompanied by all nine cheques.

Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service