2026-2027 Friends & Families 2026/27 PreK Registration 2026/27 PreK Registration Child to Enroll Name Name First First Middle Middle Last Last Child's Gender * Male Female Child's Birthday -> month/day/year * Nickname? * Child's mailing street address * City, State, ZIP * Mother (or Guardian) Mother's Name Mother's Name First First Last Last Mother's Email Mother's Phone Check if same as above same address additional address Mother's Address Mother's City Mother's Zip Father (or Guardian) Father's Name Father's Name First First Last Last Father's Email Father's Phone Check if same as above same address additional address Father's Address Father's City Father's Zip Emergency Contact (other than Parent or Guardian) Emergency Contact's Name * Emergency Contact's Name First First Last Last Emergency Contact's Email Emergency Contact's Phone Emergency Contact's Relation to Child Who may pick up the child from school? * Preschool program * choose one3 year old -> Tuesday, Thursday morning3 year old -> Monday, Wednesday, Friday morning3 year old -> Monday-Friday morning4/5 year-old -> Monday-Friday morning Does your child have any allergies that need special attention? * In order to help us to best meet the needs of your child, please answer the following questions. Check the box if the answer is YES. * Yes, this child receives support services/therapies (ie. Speech, OT, PT) Yes, this this student has an Individualized Education Program (IEP)? Yes, this student has an 504 Accommodation Plan? Yes, this student has another type of accommodation/support plan? None of the above If you answered yes to any of the previous three questions, please share some information about your child’s plans, supports, and accommodations. Please include a few words on activity level, demeanor, anticipated separation issues, etc. Personality description * Please include a few words on activity level, demeanor, anticipated separation issues, etc. Additional information * Please share any additional information you'd like us to know. While at St. Patrick's Preschool, your child may be photographed for brochures, parish website, social media. WE DO NOT IDENTIFY THE CHILD BY NAME. * PERMISSION to photograph NOT OK to photograph I accept terms and conditions * yes no INITIALS of person filling out this form Captcha Submit If you are human, leave this field blank. Online Registration Fee Payment
