Hillbrook Preschool Registration Form
Please fill out this form and click submit.  After submission you will have requested to reserve a spot at Hillbrook Preschool for your child.  You will receive an email confirmation and be given details on how to complete registration by submitting 1/2 of August's tuition.   Once payment is received you will have a confirmed spot!
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Basic Information
Child's name *
Preferred name / nickname
If they prefer to be called something other than their given name
Child's birthday *
MM
/
DD
/
YYYY
Home address
Parent / Guardian Contact Information
Parent / Guardian name *
Relationship *
Phone number (s) *
Email address *
Preferred method of contact *
Parent / Guardian name
Relationship
Phone number (s)
Email address
Preferred method of contact
Clear selection
Emergency Contact Information
Emergency Contact Person 1 *
Phone number *
Emergency Contact Person 2 *
Phone number *
List any other people you will allow to pick up your child. *
Child's Health Record
Doctor's name *
Doctors phone number *
List and describe any allergies or food restrictions your child may have. *
If no allergies exist just type 'none'
List and describe any medical conditions, speech, hearing or visual impairments of which I should be made aware.
Would there be any restrictions to play or activities?
These may be based on religious, family or personal preferences.
About Your Child
How does your child feel about going to preschool?
What is your child's temperament?
Easy going? Aggressive? Anxious? Social? etc...
Is your child potty trained? *
Can your child be relied upon to indicate bathroom needs? *
What is your child's favorite food?
What food does your child dislike?
What are some of your child's favorite activities?
Please list any siblings and specify gender and age.
Is there any other information you would like me to know about your child?
Are there any specific concerns you have about your child and preschool?
Submit
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