Milwood Preschool Registration
Fall 2017 - Spring 2018

PLEASE FILL OUT ONE REGISTRATION PER CHILD

A $100 Registration fee (per child) is also required to secure your child's spot.

Email address
Child's Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Gender
Home Street Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Mother's Name
Your answer
Mother's Cell Phone
Your answer
Texting
Mother's Email Address
Your answer
Father's Name
Your answer
Father's Cell Phone
Your answer
Texting
Father's Email Address
Your answer
Physician's Name
Your answer
Physician's Phone Number
Your answer
Person authorized to pick up your child or to contact in case of emergency & their phone number
Your answer
Person authorized to pick up your child or to contact in case of emergency & their phone number
Your answer
Person authorized to pick up your child or to contact in case of emergency & their phone number
Your answer
Church Member
If yes, Church to which you belong
Your answer
Do you have teacher preferences for your child?
We cannot promise or guarantee due to numbers, but will try to accommodate your request.
Your answer
Are there any classmates you want your child to be with?
We cannot promise or guarantee due to numbers, but will try to accommodate your request.
Your answer
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