Celebration Preschool 2020-2021 Application for Pre-K (Must be 4 years old by September 30, 2020.)
Child's First Name *
Child's Last Name *
Registration Type *
First Choice *
Second Choice
Third Choice
Fourth Choice
Fifth Choice
Name to be used/recognized in the classroom *
Sex *
Required
Age (as of September 30, 2020) *
Date of Birth *
MM
/
DD
/
YYYY
Mailing Address (City & Zip Code) *
Mother's/Guardian's First Name *
Mother's/Guardian's Last Name *
If Different From Above - Mailing Address (City & Zip Code)
Primary Phone Number *
Secondary Phone Number
Mother's/Guardians Email Address *
Father's/Guardian's First Name
Father's/Guardian's Last Name
If Different From Above - Mailing Address (City & Zip Code)
Primary Phone Number *
Secondary Phone
Father's Guardian's Email Address *
Person(s) with legal custody of child (if not parent, please indicate the relationship to child) *
Name of person to contact when parents cannot be reached *
Relationship to child *
Primary Phone Number *
Secondary Phone Number
Schools previously attended by your child and dates attended
Will your child need special services in the classroom? (speech, OT, PT, IEP, other) *
If yes, please list any special services.
Does your child have any allergies? *
If yes, please list any allergies.
Will your child require medication while at preschool? (Such as an Epi-pen) *
If yes, please list any medications.
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