Gender (Required) Please Select Which Class For Your Child (Required) Primary Morning (Age 3 by 9/1). Meets Thur & Fri 9-11am Primary Afternoon (Age 3 by 9/1). Meets Thur & Fri 12-2pm Pre-K Morning. Meets Mon, Tues & Wed 9-11:15am Pre-K Afternoon. Meets Mon, Tues & Wed 12-2:15pm
Please select which class you're interested in for your child. Note that children registering for Primary class must be age 3 by September 1.
All records at Jack and Jill are confidential. No information is given out or shared with any other persons or agencies.
Note: If parents share custody, Jack and Jill must be supplied with copies of all legally binding agreements, court directives,
and any other executed documents that are applicable.
Primary Custody (Required) Can you be contacted at your work number? Can you be contacted at your work number? Emergency Contact
This is the person who will be called if we cannot reach the parent. This person must be authorized to pick up your child if called by the preschool
List all members of the household, their relationship to the child, and their ages: (may input two names per field, if needed)
Pick up and drop off
List the people to whom you are giving permission to drop off or pick up your child on a regular basis. (e.g.: grandparents,
aunts/uncles, babysitters, neighbors, other persons.)
Please note: These are they only people who will be allowed to pick up your child at school unless specific permission is
given. If you are involved in a custody situation, the preschool needs copies of all custody papers, P.F.A.’s, or any other
documents that outline persons who are to be permitted or excluded from transporting this child.
By what name does your child know important people in their life? For example grandmothers could be nana, oma, nanny, granny, grandma, etc. Grandfathers could be called pap, pop, opa, pappy, etc. Many children have specific names for all their grandparents & we do not realize who they are speaking about when they use these terms. Likewise, aunts, uncles,
neighbors, special friends of parents may have nicknames that the children use that we might need to know.
Pets & Experiences Names of pets & types of animals, if any: List any group experiences that your child has had (babysitter, playgroup, Sunday school, daycare, dance, soccer, etc.).
Please note whether or not a parent has been with the child during these experiences
Heath background List any known allergies to food or beverages (Required) Please list all food restrictions (Required) Does this child take any medications regularly? If so, please list (Required) Does this child have any distinguishing birthmarks or physical characteristics? If so, please list (Required) Is there any reason your child should not participate in physical activities? (Required) If yes, please list the activities to be avoided and the reasons (Required) Are there any other conditions or situations that the school should be aware of when working with your child? How did you learn about Jack and Jill Preschool? (Required) Referred by member of Trinity Older child in the program Referred by a friend Ad in newspaper Saw preschool sign From J&J website What are your child’s favorite toys, games, or stories? How would you describe your child’s personality? Additional comments or remarks