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FAITH LUTHERAN CHRISTIAN PRESCHOOL
680 W. Deerpath Road
Lake Forest, IL 60045
847-234-2753
Registration Form |
| Father's Name: ___________________ |
Mother's Name: |
| Address: ________________________ |
Address: |
| ________________________________ |
________________________________ |
| Home Phone: |
Home Phone: |
| Father's Occupation: |
Mother's Occupation: |
| Bus. Name/Address: |
Bus. Name/Address: |
| ________________________________ |
________________________________ |
| Work Phone: _____________________ |
Work Phone: _____________________ |
| Work Hours: ____________________ |
Work Hours: ____________________ |
| Church where member: _____________ |
Church where member: _____________ |
| Marital status of parents: ____________ |
Custody, if divorced: _______________ |
| Legal guardian: ___________________ |
Child's physician: __________________ |
| Guardian address: _________________ |
Physician's address: ________________ |
| ________________________________ |
________________________________ |
| Guardian phone: __________________ |
Physician phone: __________________ |
| In an Emergency, my child may be released to:
____________________________ |
| Phone Number: ___________________ |
Relationship: ____________________ |
|
|
| Class in which child is to be enrolled: |
|
| __________ Tue/Thurs
9:00-11:30AM - 3 year old |
| __________ Mon/Wed/Fri
9:00-11:30AM - 4 year old |
|
| * An enrollment fee of $150 is due with this
form |
|
|
| I have read the Parent Handbook and will abide
by all the standards set by this preschool including the Discipline
Policy. |
| Parent's Signature: ________________ |
Date: __________________________ |
| Parent's Signature: ________________ |
Date: __________________________ |
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| Admission Date: __________________ |
Discharge Date: __________________ |
