Student Registration

Are you a Mt. Baker Co-op Preschool Alumni family?YesNo

If so, please list the alumni student's name:

Child Information:

Child's First, MI:

Childs Last Name:

Date Of Birth: (YYYY-MM-DD)

Gender:
MaleFemale

Parent or Legal Guardian's Full Name:

Street Address:

City:

State:

Zip Code:

Mailing Address (if different than above):

Main Phone Number:

Additional Phone Number:

Email Address (used for communication purposes):

Class Selection

Please let us know your preferred class.

If a class is full you may still be added to the waitlist.

Child must be 3 years old and fully potty trained by September 1st.

—Please choose an option—Class A: Mon/Tue, 9:30AM - 12:30PM-FULL / Ages 3-5Class B: Wed/Thu, 9:30AM - 12:30PM-FULL / Ages 3-5

If your first desired class is full, please select if you have a second choice. You will be placed on the waitlist of your first choice and then enrolled in your second choice.
—Please choose an option—Class A: Mon/Tue, 9:30AM - 12:30PM-FULL / Ages 3-5Class B: Wed/Thurs, 9:30AM - 12:30PM-FULL / Ages 3-5

Emergency Contact Information

Emergency Contact (other than parent):

Emergency Phone:

Who has permission to pick your child up from school?

Person's authorization can be added and removed at any time.

First and Last Name:

Phone Number:

First and Last Name:

Phone Number:

First and Last Name:

Phone Number:

Health Questionnaire

Does the student have any allergies?
YesNo

If yes, please indicate (if no, not required):

Does the child have any medical conditions that the teacher should be aware of?

YesNo
If yes, please indicate (if no, not required):

Are you interested in learning more about serving on the Preschool's Board of Directors? YesNo

*IMPORTANT*
As a coop parent, I understand the
following requirements are necessary and required of me and/or an alternate
caregiver in order for my child to be enrolled in the Mt. Baker Co-op Preschool:
*Attend the parent orientation
*Attend the MANDATORY monthly parent ed
meetings
*Participate in the classroom as a
working parent
*Complete a parent job
*Participate in the fundraising events
Please ask any questions before
enrolling you child. More details will be given at the orientation before
school starts.
Our Co-op is only as good as every
parent makes it!

I have read, understood, and agree with the above Parent Requirements

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