Day School Registration Form Child InformationChild's Name *Child's Nickname Address *Home Phone Number *Birthday *Age as of Sep. 30 *My Physical Consideration: (hearing loss, eyeglasses, extreme hyperactivity, etc.) Parent InformationFather's Name *Occupation Address Phone Number Mother's Name *Occupation Address Phone Number Child lives with Both ParentsMotherFatherOtherYour Church Affiliation MembersAttendingVisitingEmail Address Please check the box for acknowledgement of the fee in reserving your child's place. Registration fee is $100.00. VerificationPlease enter any two digits *Example: 12This box is for spam protection - <strong>please leave it blank</strong>:
