Registration Form
Discovery Montessori
1026 Sidney Ave #160
(360) 337-5745

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      School Year
Grade		 ______________
______________
Childs Name
First - Last name		 ________________ ________________ Birthdate ______________
Address ________________
Street
________________

 Home Phone ______________
  ________________
City
 ________________
State
 ___________
zip code 		 
Mother
First - Last name		 ________________ ________________ Phone ______________
Father
First - Last name		 ________________ ________________ Phone ______________
Other
Parent/Guardian
First - Last name		 ________________ ________________ Phone ______________
Address ________________ ________________ ______________ ______________

Persons (not parents)for emergency contact
First - Last name

       
Name_______________ Phone________________ Relationship___________ Pickup Yes/No  
Name_______________ Phone________________ Relationship___________ Pickup Yes/No  
Medical facts, or other that we need to know about your child. I.e. allergies, medications, handicaps, etc.


________________


_________________


______________


______________
What do you hope this preschool experience will provide for your child?

________________

_________________

______________

______________
Preschool-is your child potty trained? Yes/No        
How long has your child been potty trained?
________________ 		     
How many siblings and their ages 1.__________age_______ 2.___________age________ 3.________age_______  
Circle ALL Preferences        

Summer

AM. Daycare
(7:00 - 9:00)

How Many
Days?




A.M. Session
(9:00 - 11:00)

Five Days
(M-F)


P.M. Session
(12:30 - 3:00)

Three Days
(M-W-F)


P.M. Session
(12:30 - 3:00)

Two Days
(T-Th)
P.M. Daycare
(3:00 - 5:30)

Fall

Preschool:

 

 

 

 A.M. Daycare
(7:00 - 9:00)

Five Days
(M-F)

 

 A.M. Session
(9:00 - 11:30)

Three Days
(M-W-F)

 

 P.M. Session
(12:30 - 3:00)

Two Days
(T-Th)

 

P.M. Daycare
(3:00 - 5:30)





 

Kindergarten:

A.M. Daycare
(7:00 - 8:45)

A.M. Session
(8:45 - 11:30)

P.M. Session
(12:30 - 3:15)

P.M. Daycare
(3:15 - 5:30)

Elementary:
(8:45 - 3:15)


A.M. Daycare
(7:00 - 8:45)

 


Kindergarten

 


Circle Grade
1 2 3 4

 


P.M. Daycare
(3:15 - 5:30)

 
Daycare Hours needed   Registration fee paid:

Amount ___________
check # ___________

 Date:
Parent Signature