5 minutes
In order to fill out a kindergarten registration form, your child must be five years old by December 31st of the year they begin kindergarten.
First Name
Last Name
Gender
Birth Date
Home Phone
Address
City
State
Country
Zipcode
Parent/Guardian Information
Name
Area
Phone Number
Work
Address - Same As Child
Would your child like to be in a class with a friend
If yes, name and age of friend(s)
Is your child immunized
Does your child have any allergies
If yes please list, including any food or drug allergies
Does your child have any medical conditions
Does your child require any medication? If yes, please list these medications
Do you authorize us to administer the medications listed above
Please list the people authorized to pick up your child
Does your child have any siblings
If yes, what is their age
Comments
Signature
Signed Date