Preschool Registration Form - Design 3
Date of Birth
Does your child suffer from any allergies, illness, disability or other medical conditions?
Please describe below.
Has your child completed all required immunization?
Please list immunizations that have been administered to your child.
Please list immunizations that have NOT been administered to your child.
Do you permit your child to be immunized at school?
Please type your full name to give your consent for your child to be immunized at school:
Please give reason:
Is there any other information or issues you would like the teachers to know?
Please select preffered programs:
2 days tuition a week
3 days tuition a week
4 days tuition a week
5 days tuition a week
before school care
after school care
before & after school care
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