Little Learners Academy Registration Form
Tell us a little bit about you and your child so we can best assist you and your family - Please fill out 1 form per child to be enrolled.
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Parent(s) Name(s) *
Child's Full Name *
Nickname
Sex *
Age *
Date of Birth *
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Mobile Phone Number *
E-mail Address *
Address *
Desired Start Date *
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YYYY
Length of Days *
Which Days of the Week? *
Required
Catered Lunch?  ($3.50/per day) *
Does your child have any allergies? *
Give three words that best describe your child? *
What comforts your child? *
What type of discipline do you use at home with your child? *
Does your child have any special needs or circumstances that we should know about? *
What are your child’s interests? *
What are your child’s dislikes? *
Is there anything special you’d like us to know about your child? *
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