Registration Form
Please return with $ 50.00.
I understand that the
expenses of operating the Crescent Hill Presbyterian Church
Pre-School remain the same whether my child is in school or
not. I agree to enroll my child for the entire
2008-2009
school year.
Child’s
name__________________________________________ Goes
by__________________
Date of
Birth__________________________________________
(month)
(day) (year)
Address__________________________________________ Phone
Number__________________
(street, city,
zip code)
Father’s
name_____________________________________
Occupation______________________
Mother’s
name____________________________________
Occupation______________________
Siblings (with
ages)________________________________________________________________
Father’s business
phone_______________________ Mother’s business
phone___________________
Has child been to
pre-school?__________________
Where?________________________________
Physician’s
name____________________________ Phone
number__________________________
Emergency
phone____________________________ Left-handed or
right-handed?_______________
Allergies or special
needs___________________________________________________________
Church
affiliation_________________________________________________________________
Classes offered: Check all
that apply.
_____ 2 years old (9 A.M.
until 12 Noon, Tuesday, Wednesday, Thursday)
_____ 3 and 4 years old
PRESCHOOL (9 A.M. until 12 Noon, Monday through Friday)
_____ 3 and 4 years old
EXTENDED DAY (12 Noon until 3 P.M. Monday, Tuesday,
Wednesday,
Thursday)
Please bring immunization
form from doctor.
____________________________________
Signature of Parent
Mail to Crescent Hill Presbyterian Preschool, 142 Crescent
Avenue, Louisville, KY 40206.
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