Midweek Mix: Preschool Registration

Child's Name*

Child's Birthdate*

Address

,

Parent's Name*

Parent's Cell Number*( ) -

Parent's Email

While your child is in class, where will you be?*

Does your child have any known allergies?

Please leave this field blank.

138 S. Washington Street Prattville, AL 36067

334-365-0606

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