Free Daycare Registration Form Template

Daycare Registration Form

Please fill out this form to register your child in our daycare program.

Child Information

Name

    Date of Birth

      Gender

        • Male

        • Female

        Address

          Parent/Guardian Information

          Name

            Relationship to Child

              Phone number

                Email

                  Medical Information

                  Allergies

                    Special Needs or Requirements

                      Primary Care Physician

                        Phone number

                          Please check the box below to proceed

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