Registration Form 2 of 2
for
Amee’s Preschool
Child’s Name:__________________________________________________________________
Age:_________________________________________________________________________
Birthday:______________________________________________________________________
Address:______________________________________________________________________
Home phone number:_____________________________________________________________
Mother’s Name:_________________________________________________________________
Mother's Cell number_____________________________________________________________
Father’s Name:__________________________________________________________________
Father's cell number:______________________________________________________________
Work phone numbers for parents:___dad______________________________mom_______________________________
email address:__________________________________________________________________
In case of Emergency, contact:________________________________________________________
Phone Number of emergency contact:_________________________________________________
Please list any health problems I should be aware of, including allergies and other concerns:_______________________________________________________________________
______________________________________________________________________________
I give permission to Amee Guy to perform or seek any medical attention needed immediately for my child___________________________
___________________________ _______________
Parent or Legal Guardian Date