Application - 2018-2019 School Year
Thank you for your interest in Primavera. Please fill out this registration form with information about your child and their desired enrollment.
Desired date of enrollment
Child's Name *
Your answer
Child's Birthday *
MM
/
DD
/
YYYY
Child's Gender *
Indicate your desired days of enrollment *
* Children under 2 years of age are eligible to participate in a two-day program only (M/W or T/Th). We highly recommend that children ages 3 years and older participate a minimum of3 days/week.
Required
School Attended (if any)
Your answer
Home Address
Your answer
Home Phone *
Your answer
Developmental Needs
Does your child have any special developmental needs about which we should be informed of? (emotional, physical or intellectual, including speech and language development)
Your answer
Dietary Restrictions
Does your child have any dietary restrictions, i.e. vegetarian, vegan or any food allergies?
Your answer
Tell us about your child
Your answer
Would you like to enroll additional children?
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