Miss Tanya's Storybook Adventures Enrollment Form 9:00

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Miss Tanya's Storybook Adventures Enrollment Form 9:00 - 11:15am

Child's Full Name *

Mother's Full Name *

Father's Full Name *

How did you hear about A Place To Grow Preschool?

Child's Date of Birth *

Gender *

Female

Male

Address *

Contact Phone Number *

Alternate Phone Number *

Email Address *

Allergies/Medical Conditions

Emergency Contact/Authorized People To Pick Up Your Child *

First Choice Second Choice (Name, Full Address, Phone Number)

Emergency Contact/Authorized People To Pick Up Your Child *

Second Choice Second Choice (Name, Full Address, Phone Number)

Emergency Contact/Authorized People To Pick Up Your Child *

Third Choice Second Choice (Name, Full Address, Phone Number)

Person(s) NOT AUTHORIZED to pick up your child

Photo Release *

Photographs of my students will be taken during classroom activities, projects and special events. These photographs may be posted on the preschool's Facebook page, the preschool website, or promotional material. Please check your preference for photo release:

I DO give permission for my child to be photographed for use in class projects, on the Preschool Facebook page, the preschool website, and/or promotional material.

I DO NOT give permission for my child to be photographed for any reason.

Liability Release *

I release A Place To Grow Preschool from any and all liability arising from claims for injuries or damages to my child and/or property while my child is on the school premises and/or participating in class activities.

Yes

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