Nursery School (Age 0-3) Registration Form
We have curriculum available for ages 0 through 3 years old! ​Please fill in the form below and Maxine will make sure you receive the materials.
Email address *
Child's Name *
Your answer
Child's Age *
Your answer
Child's Birthdate *
MM
/
DD
/
YYYY
Allergies? (Write "None" if no allergies) *
Your answer
Parent's Name(s) *
Your answer
Parent's Street Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Phone Number *
Your answer
Emergency Contact Number *
Your answer
Parent's Email (so we can send info) *
Your answer
Check one of the boxes below: *
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