Faith Baptist
Preschool Academy
Registration Form

Child Information

Child's First Name

Child's Last Name

Birthdate

Gender

Allergies

Yes

No

List of Allergies

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Parents Information

Dad's First Name

Dad's Last Name

Dad's Cell Number

Dad's Work Number

Dad's Email

Church

Mom's First Name

Mom's Last Name

Mom's Cell Number

Mom's Work Number

Mom's Email

Church

Other Information

Childcare Provider

Childcare Provider Phone Number

Emergency Contact First Name

Emergency Contact Last Name

Emergency Contact Phone Number

Session Enrolled

Please choose one of the following options for your child:

Small Fry Wed AM

First Step Tues/Thurs AM

First Step Mon/Wed/Fri AM

First Step Tues/Wed/Thurs PM

Pre-K Mon-Thurs AM

Pre-K Mon-Thurs PM

Pre-K Mon-Fri AM

Enrichment M-F AM

Faith BaptistPreschool Academy Registration Form

Child Information

Parents Information

Other Information

Session Enrolled

Faith Baptist
Preschool Academy
Registration Form