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Registration Form 2013-2014

This document contains a preschool registration form for Beautiful Savior Lutheran Church. It requests information such as the child's name, address, parent contact details, preferred session, and payment amount. Additional sections gather details on the child's family, health, emergency contacts, and doctor. The form is to be mailed back to the church with a $50 non-refundable registration fee.

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paulbslc
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52 views1 page

Registration Form 2013-2014

This document contains a preschool registration form for Beautiful Savior Lutheran Church. It requests information such as the child's name, address, parent contact details, preferred session, and payment amount. Additional sections gather details on the child's family, health, emergency contacts, and doctor. The form is to be mailed back to the church with a $50 non-refundable registration fee.

Uploaded by

paulbslc
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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BEAUTIFUL SAVIOR LUTHERAN CHURCH

Referred by:

Preschool Registration Form


Child's Name________________________________________ Age______ Date of Birth__________________
Address _________________________________________City______________________ (Zip) _____________
Cell Phone: (father) ______________________________ (mother) ____________________________________
Home Phone: _______________________________ Email: _________________________________________
*Please mark the session for which you are registering:
Preschool 3 year old Tuesday and Thursday

8:45 - 11:15am.

8:45am 12:15 pm $140.00

Preschool 4 year old Monday, Wednesday, Friday

$105.00

8:45am -11:15am

$130.00

8:45am 12:15 pm $175.00

Father's Name

Employer

Telephone

Mother's Name

Employer

Telephone

Child lives with: Father & Mother

Father

Mother

Other

Sitter (if parents are working)


Name
BROTHERS & SISTERS
NAME

AGE

SCHOOL

_________________ Members? Yes, No

Church Affiliation

Does the child attend Sunday school? Yes, No

HEALTH PROBLEMS
Describe any health problems the child has:
Describe the child's previous experiences in a group (personality, likes, dislikes, fears, etc.):

EMERGENCY INFORMATION
Emergency contact if you cannot be reached:

(#)

___ ___

Family Doctor: ____________________________________________________________________________


(Name)

(Telephone Number)

NOTE: Mail this registration form to Beautiful Savior Lutheran Church; 9800 S.E. 92nd Avenue; Happy Valley, OR
97086, with a $50, non-refundable registration fee.
Edited 3.26.2013

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