Daycare and Preschool Registration | Faith Baptist Church

FAITH CHRISTIAN ACADEMY DAYCARE

Registration Form

This form must be completed fully in order for it to be complete and valid. All signature fields must be signed and the date selected. If it is not completed correctly, you may be asked to completely again.

Before student can be enrolled in daycare or preschool, the following documentation is required:

● Copy of Birth Certificate

● Copy of Social Security Card

● Immunization Record

● Completed Student Admission Packet

● Registration Fee (due yearly)

● 1st Week of Daycare Fee

PART 1 - STUDENT AND PARENT INFORMATION

Child's Full Name (first, middle, last)

Child's Date of Birth

Month

Day

Year

Child's Age

Sex

Child's Social Security Number

Child Lives With:

Both parents

Mother

Father

Other

List your child's allergies, illnesses, medical conditions and current medications. If none write NA.

Name of Church Family Attends:

Mother's Full Name

Mother's Date of Birth

Month

Day

Year

Mother's Cell Phone Number

Mother's Email

Mother's Full Address

Mother's Employer

Mother's Work Number

Father's Full Name

Father's Date of Birth

Month

Day

Year

Father's Cell Phone Number

Father's Email

Father's Full Address

Father's Employer

Father's Work Number