Child Info Form

Child's Name:

Birthdate:

My child prefers to be called:

Parent/Guardians Name:

Address:

Contact:

Second Contact: 

Email Address:

To help us be more sensitive to your child's family situation, please check:

Child lives with:

_____ Both Parents

_____ Single Mom/Dad

_____ Parent & Step Parent

_____ Foster Parent

Does your child have any food/drink or other allergies? If so, please list:

Does your child have any fears (loud noises, animals ect.)

What are some of your child's favorite activities?

What are your child's favorite snack foods?

What is your child most interested in/least interested in?

What do you expect your child to gain from this experience?

Is there any other information you would like us to know about your child in regards to emotional development and social behavior?

During preschool, my son/daughter may be picked up by the following people:

Name/ #'s

_____ Parents Only - unless written note accompanies child to class  

If you have any questions, please give us a call at 208 660 5532.

Thank you for chosing Cochran Lane Preschool and Welcome to our Preschool family