DayCare Registration Form

All kids need to be registered at daycare. And we’re here to help you get that done, as fast and easy as possible.

Questions for DayCare Registration Form

1.

Child's Legal Name

The answer should be a text input.
2.

Birth Date

The answer should be a date input.
3.

Preferred Name

The answer should be a text input.
4.

Gender

The answer should be a single choice:
  1. Male
  2. Female
  3. Others
5.

Address 

The answer should be a text input.
6.

City

The answer should be a text input.
7.

State

The answer should be a text input.
8.

Country

The answer should be a country.
9.

Zipcode

The answer should be a number input.
10.

Home Phone Number

The answer should be a phone number.
11.

Parent / Guardian Information

Father/Mother's Name

The answer should be a text input.
12.

Address

The answer should be a text input.
13.

Occupation

The answer should be a text input.
14.

Name of Employer

The answer should be a text input.
15.

Work Phone Number

The answer should be a phone number.
16.

Work Hours

The answer should be a text input.
17.

Work Address

The answer should be a text input.
18.

Parent/Guardian with legal custody

The answer should be a text input.
19.

Parents are: (please check one)

The answer should be a single choice:
  1. Married
  2. Living together
  3. Divorced
  4. Seperated
  5. Widowed
  6. Single
  7. Others
20.

Child Pickup Information

Name

The answer should be a text input.
21.

Age

The answer should be a number input.
22.

Relationship

The answer should be a text input.
23.

Signature

The answer should be a signature.
24.

Signed Date

The answer should be a date input.

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