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Today’s Date:___________________ |
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First Baptist School Registration Kindergarten |
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Date of Birth:__________ Place of Birth_____________ Current Age_______ Child’s Name:_______________________________________ Male Female Home Address:__________________________________________________ City:_________________________________________Zip Code:_________ Days Requested: (Please Circle) Half Day Full Day Special Instructions:_____________________________________________ Allergies_______________________________________________________ |
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Person responsible for child Primary Name:__________________________________________________ Address: _______________________________________________________ City ___________________________________Zip:____________________ Home Phone:___________________________Cell:_____________________ Employer:______________________________________________________ Address:________________________________________________________ City:_________________________________Work Phone:_______________ Social Security # ____-____- _______ Secondary Name:________________________________________________ Address: _______________________________________________________ City ___________________________________Zip:____________________ Home Phone:___________________________Cell:_____________________ Employer:______________________________________________________ Address:_______________________________________________________ City:_________________________________Work Phone:_______________ Social Security # ____-____- _______ Church Affiliation________________________________________________ |
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Office Use Only Registration Fee:_______Check#_________ Handbook ____Parent Agreement ____ Forms_____ Computer_______ Forms and Agreement Returned__________ File _________Blue Card________ |
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Non-Refundable Registration Fee is due upon registration |
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Office use only Room#__________ HD_________FD________ |