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Child's Name(Required)
MM slash DD slash YYYY
Address(Required)

Parent 1 Information

Name(Required)
Business Address(Required)

Parent 2 Information

Name(Required)
Business Address(Required)

Program of Interest

Emergency Information

Emergency Contacts

The following persons are authorized by me to pick up my child from school if I am unable to do so AND may also be called in an emergency if the parent/guardian cannot be reached. (Please list at least 2 local names and numbers - not the child's parents).

Authorized Pickup Contacts

The following persons are authorized by me to pick up my child from school if I am unable to do so. (Please list at least 2 local names and numbers - not the child's parents).
IGNORE THIS SECTION. EMPTY CONTENT

Permission Form Information

3. I/We grant permission for my child to be photographed or videotaped for usage in the school’s marketing and publicity which can include but not limited to website, promotional materials, internet and social media.(Required)
6. I/We grant permission for my child's teacher and the Director to contact my child's prior preschool and prior/current service providers.(Required)
7. I/We grant permission for First Presbyterian Church of Fairfield to email me/us with information related to church events.(Required)

Parent Agreement

Binding Tuition Agreement

Presby Kids happily accepts your child into our school community for the upcoming academic year. Children are accepted for the entire school year or for the remainder of the school year if enrolled after the opening date.