Student
Registration Form
Student’s Full
Name:__________________________________________________
Name You Want Your Child to
Write:_____________________________________
Age (by first day of
school):_______ Date of Birth:__________________________
Mother’s
Name:_____________________________Phone:____________________
Father’s
Name:______________________________Phone:____________________
Other Emergency Contact
Name:__________________Phone:__________________
Preferred Email
Address:________________________________________________
Home
Address:________________________________________________________
Text? Y/N
Do you give permission to send pictures via email of your
child in the preschool setting in preschool group emails? Y/N
Does your child have any allergies? Y/N
Specify:________________________________
Does your child have any conditions or behaviors that affect
play/learning? Y/N
Describe:______________________________________________________________________
Any other information about your
child that would be helpful to
know:________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Is your Child Potty Trained?
(Please let me know if this changes throughout the school year.) Y/N
Child’s
Interests:___________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
I,
________________________________________________, agree to register/enroll my
child in Sprouts Preschool instructed by Karri Sloan for the 2015-2016 school
year. I agree to pay the monthly tuition
of $65 by the 1st day of
preschool every month. Tuition may be
paid by cash or check, made payable to Karri Sloan. I understand that tuition cannot be refunded
for illness or any other reason.
To hold my child’s place in this
preschool, and to help purchase supplies for the school, I agree to pay the
registration amount of $65, which is also non-refundable.
Finally, I agree to follow the
rules and guidelines as outlined in the Policies and Procedures.
Parent/Guardian Signature:___________________________________________________
Date:_____________________________________
Submit Registration form and $65
registration fee to:
Karri Sloan
1116 Arklow Ct.
Idaho Falls, ID 83404
