Registration

For which class are you registering (choose one)?
NurseryToddlerTwo'sThree'sFour's

Child's Name

Sex
MaleFemale

Date of Birth

Address

City, ST, Zip

Primary E-mail address

Primary Phone

FAMILY INFORMATION:

Mother's Name

Occupation

Employer

Mobile Phone

Work Phone

Father's Name

Occupation

Employer

Mobile Phone

Work Phone

Please list other children in the family and their date of birth.

Does your family have a religious preference?
YesNo

If so, where do you currently worship?

If you would like to receive text notifications about school events, please list the cell number(s) and carrier(s) you would like to use below:

CHILD RELEASE AUTHORIZATION
I give permission for the following person(s) to pick up my child from Sonshine PreSchool or be contacted in case of an emergency when a parent cannot be reached. At least one person must be listed:
Name #1PhoneRelationship

Name #2PhoneRelationship

Name #3PhoneRelationship

The following people MAY NOT pick up my child (if needed):

MEDICAL INFORMATION
PhysicianPhone

DentistPhone

Hospital

Any medical conditions we need to be aware of?
YesNo
If yes, please describe

Please list any allergies, including any physical/behavioral side effects:

IMMUNIZATION RECORD
We must have a current immunization record on each student every year. Please bring a copy of your child’s record to the Sonshine PreSchool office, or you may call your pediatrician’s office and have it faxed to us at 806-763-7331. A copy of this form is kept on file both in the office and with your child’s teachers in case of emergency.

PARENT AUTHORIZATION
By filling out this form, I, do hereby state that I am the parent or legal guardian of and that all the information I have provided on this form is complete and accurate to the best of my knowledge. In the event that I cannot be reached while my child is in the care of Sonshine PreSchool, I give permission for the Sonshine PreSchool staff to authorize emergency treatment for my child.

*You will be required to physically sign and date a copy of this form in the Sonshine PreSchool office before your registration is completed. A $75 Registration/Supply Fee will also be due at that time.