Registration | Carefree PreSchool

Child's Information

Child's First Name

Child's Last Name

Child's Birth Date

Child's Phone No

Child's Address

Child's City

Child's Province

Child's Postal Code

Medical Information

List all allergies, if any:

Does your child require an EPI-PEN?

YES

NO

If OTHER, please specify

Please provide any Medical or other Instructions that may be helpful to teachers:

Does your child have any special requirements for Diet, Rest or Exercise?

YES

NO

If YES, please specify

My child is toilet trained

YES

NO

Emergency Contact & Pickup Information

Emergency Contact Name

Emergency Contact Phone

Person(s) authorized to collect the child: A child will not be released to anyone unless authorized on this form.

Authorized Pickup-1 Name

Authorized Pickup-1 Phone

Authorized Pickup-2 Name

Authorized Pickup-2 Phone

Parent / Guardian Information

Parent / Guardian - 1

PG1 First Name

PG1 Last Name

PG1 Phone

PG1 Email

Address

PG1 City

PG1 Province

PG1 Postal Code

What is the name of the school you attend or the company you work at?

What is the address of the School or the company?

What is your school or office phone number?

Parent / Guardian - 2

PG2 First Name

PG2 Last Name

PG2 Phone

PG2 Email

Address

PG2 City

PG2 Province

PG2 Postal Code

What is the name of the school you attend or the company you work at?

What is the address of the School or the company?

What is your school or office phone number?

Are there any custody arrangements?

YES

NO

Custody arrangement details

ENROLLMENT

Enrollment Form

Child's Information

Medical Information

Emergency Contact & Pickup Information

Parent / Guardian Information

About Us

Carefree Preschool

Operating Hours