* Required

Student Information:

Parent/Guardian Information:

If your child becomes ill during the day and needs to leave, please list in order of importance, the names of four adults, including yourself and/or spouse, along with the day time phone numbers. It is understood that those listed have your permission to pick up your child

List the names of all children in the household, including their date of birth, relationship, and current school.

Kindergarten Parent Questionnaire

Prior to entering Kindergarten, my child has been cared for in the following ways. Please check all that apply: (Full-Time: more than 24 hours per week, Part-Time: less than 24 hours per week)

Help us learn more about your child before they start school: