Today’s Date_______________________________
Child’s name:__________________________ Sex: M F Birthdate:______________
Parent’s Names_______________________________ Phone:____________________
Street Address (street, city, state and zipcode):__________________________________
E-mail Address:__________________________________________________________
How would you like you child to spell his/her name? (ex. Tom/Thomas) _____________
Class Preference: _________________________________________________________
Morning: 3 days Tuesday, Wednesday, Thursday 9:00 – 11:30
Afternoon: 3 days Tuesday, Wednesday, Thursday 12:30 – 3:00
The Preschool is
moving back to the
Please send the complete registration form along with $25 non-refundable registration fee to: Angie LaBay
906-420-5441
Make Checks payable to: The Gladstone Preschool