Registration form | Lakeview Community Preschool

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Program

3 year old

4 year old

Preference

AM

PM

Student information

First name

Middle name

Last name

Date of birth

Male

Female

Street Address

City

Postal / Zip code

Parent email for preschool communication

Parent phone for preschool communication

Parent 1 information

First name

Home phone

Last name

Cell phone

Email

Home address (if same as student, write same)

City

Postal

Occupation

Employer's name

Employer address

City

Postal

Business phone number

Business email:

Parent 2 information

First name

Home phone

Last name

Cell phone

Email

Home address (if same as student, write same)

City

Postal

Occupation

Employer's name

Employer address

City

Postal

Business phone

Business email:

Emergency contact (not a parent)

First name

Home phone

Last name

Relationship

Cell phone

Business phone

Home address

Student doctor's name

Student doctor's phone

Student Alberta Health Care #

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