Trinity Lutheran Preschool

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Regristration Form 

Child Information:

 

Child’s Full Name_________________________________________________________

 

Male ____  Female ____  Date of Birth _______________________________________

 

Previous Preschool Experience ______________________________________________

 

Trinity Lutheran Church Preschool is open to all children regardless of religious affiliation.
 Please complete the following:

____ Attend or a member of Trinity Lutheran Church

____ Attend or a member of ________________________________________________

____ Currently unchurched

Allergies/Food Restrictions/Other Special Needs ________________________________

 

________________________________________________________________________

 

Parent/Guardian Information:

 

Name of Mother__________________________________________________________

 

Employer _________________________  Home phone number ____________________

 

Home address ____________________________________________________________

 

Name of Father___________________________________________________________

 

Employer __________________________ Home phone number ___________________

 

Home address ____________________________________________________________

 

Father Work Phone __________________ Mother Work Phone ____________________

 

Father Cell Phone   __________________ Mother Cell  Phone   ____________________

 

Individuals authorized to pick up or receive your child:

(Name)                                                                                   (Relationship)

____________________________________________________________________________________

 

_______________________________________________________________________

 

_______________________________________________________________________