If you are registering more than one child please use one form per child. |
| Preschool Location: * |
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| Your name: |
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| Child's name: * |
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| Child's date of birth: * |
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| Parent/Carer's name(s): * |
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| Address: * |
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| Postcode: |
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| Home phone: |
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| Mobile phone: |
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| Email address: |
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| Other contact details: |
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| From what date do you require a place for your child: |
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| What MORNINGS do you require: |
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| What AFTERNOONS do you require: |
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| Any special requirements needed for your child: |
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