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Bay Area Preschool Registration Form

Child's Information:
First Name: Last Name:
DOB:
School: Grade:
Allergies:
Other exposure to Spanish?
Parent's Information:
First Name: Last Name:
Home Phone: Mobile:
Address:
City: Zip:
email:
First Name: Last Name:
Home Phone: Mobile:
Address:
City: Zip:
email:
Emergency Contact:
First Name: Last Name:
Relation: Phone:
Select your desired campus:
Montclair
Walnut Creek
Select your preferred schedule:
Form completed by: