Jerome Christian Church Preschool

Registration Process Will Be Complete

After All Communication/Paperwork With Jodi Miller

Has Been Completed.


Preschool Pre-Registration Form
Parent/Guardian Information
Father's/Guardian's First & Last Name
Father's/Guardian's Date of Birth
Mother's/Guardian's First & Last Name
Mother's/Guardian's Date of Birth
Street Address
City
State
Zip
Home Phone Number
Cell Phone Number
E-mail
Click Button If Any Custody Issues
If Custody Issues Please Explain If Any
Emergency Contact & Phone Number
Child's Information
Child's Full Name
Child's Date of Birth
Age of Child
Gender of Child
Enter Special Needs If Any
List Any Food Allergies /Allergies If Any
Other Family Information
Brothers/Sisters
List Any Pets And Their Names
Click This Button If You Are Interested With Helping on Field Trips