Nursery School Registration Forms

New Covenant Nursery School Registration Form

Student Information:

Child’s Name:                                                                                Date of Birth:

Nickname (if any):                                                                        Gender:

Primary Mailing Address:

Primary Home Address (only if different than above):

Known Allergies (if none please write “none”):

Name/Office Number of Pediatrician:

***Please provide a copy of your child’s general physical and immunization record (required by law) along with your registration or before the start of school.***

Parent/Guardian Information:

Parent #1 Name:                                              Parent #2 Name:

Parent #1 Street Address*:

Parent #2 Street Address*:

Parent #1 City, State, Zip*:

Parent #2 City, State, Zip*:

(*only if different than student)

Parent #1 Home Phone (with area code):

Parent #2 Home Phone (with area code):

Parent #1 Cell Phone (with area code):

Parent #2 Cell Phone (with area code):

Parent #1 Email:

Parent #2 Email:

Parent #1 Workplace Name:

Parent #2 Workplace Name:

Parent #1 Workplace Phone Number:

Parent #2 Workplace Phone Number:

How did you hear about New Covenant Nursery School?

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Help us get to know your child:

Siblings, family members, pets or special people your child might talk about:

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Favorite activities/games/toys:

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Favorite books/movies/TV shows and/or characters:

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Favorite snack:

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Daycare/school/group learning experiences:

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Any fears or dislikes the teachers should know about?

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When your child is feeling badly, what do they find helpful/soothing?

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NCNS celebrates student birthdays as well as most of the standard holidays that fall within our school year, such as Halloween, Thanksgiving, Christmas, New Year’s, Valentine’s Day, St. Patrick’s Day, Easter and Mother’s Day. Please write any holidays we have not listed that you celebrate as a family, or any information you’d like us to have about holidays.
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