Student Registration Form
Parent/Guardian Contact Info
First Name
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Last Name
Email
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Phone
*
Student Information
Child 1 Full Name
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Child 1 Date of Birth
Child 1 Photo (Profile)
Child 1 T-Shirt Size
*
Child XS
Child S
Child M
Child L
Does your child have any conditions that will affect play/learning? Please type YES or NO. If YES, please list conditions.
Beginning Assessment
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Social Skills
Letter Names
Letter Sounds
Letter tracing
Blending
Reading
Numbers 1-10
Numbers 11-20
Counting
Sorting
Pattern Recognition
Movement, agility
Emotions
Cutting (Scissor skills)
Colors
Coloring
Glue use
Write his/her name
Follow 1-2 step instructions
Contact Opt-in
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Marketing Social Media Release
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I AUTHORIZE the use of photos and/or video for marketing social media purposes.
I do not authorize
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