The Flock Preschool

      Pre-registration Form

Child’s Name:____________________________________________  Birthdate:__________

                              First Name                        Last Name

Address:________________________________________________________

City:______________________  State:___________  Zip:________________

Phone Numbers:_____________________________________________________________

                                  Home                                         Work                                        Cell

Parents’/Guardians’ Name:__________________________________________

Relationship to Child:_______________________________________________

Concerns/Comments:

Below is a list of the programs that will be offered at The Flock for the 2008-2009 school year.  Please put an “X” in the box next to the program in which you would like to enroll your child.