the Grove :: Register Your Child Here!

Use the form below to register your child for our Little Tree Learners. If you prefer to fill out a paper registration, click here to download the form!

ATTENTION: 3 year old and Pre-K classes are almost full. Please call to confirm availability.

Little Tree Learners Registration Form

General Information

Child's Full Name *

Home Phone *

Home Address *

City *

Zip *

Father/Guardian Information

Father or Guardian Name

Email Address

Address *

Home Number

Cell Number

Work Number

Employer

Employer Address

Mother/Guardian Information

Mother or Guardian Name

Email Address

Address *

Home Number

Cell Number

Work Number

Employer

Employer Address

Emergency/Medical Information

If neither parent or guardian can be reached in case of an emergency, please call

Name *

Phone Number *

Relationship to Child *

Medical Information

Child's Doctor *

Doctor's Address and Phone

Child's Dentist *

Dentist's Address and Phone

Hospital of Choice *

Insurance information and Group Number *

Please list any known allergies your child may have *

What medication(s) does your child take on a regular basis? *

Family/Home Information

Other children in family

The child lives with *

Child's Normal Schedule

Feeding times

Breakfast

Lunch

Snack

Foods they generally eat

Nap Time

Nap Times

How long does your child generally nap?

Routine for putting child to sleep?

Does your child have a comfort item for resting? If so, what is it?

Other

Does your child require a pacifier?

Is your child toilet trained?

If so, do they require assistance?

What words does he/she use for the bathroom?

Please note that children entering the Pre-K 4/5 Class MUST be fully potty-trained

Information About Child

Please give information that will be helpful to your child's teacher.

Fears

How is child comforted?

How does child express frustration?

Favorite toys and games

Other favorite things

The child's temperament is usually...

Does your child have any special needs or behaviors we need to be aware of?

Food allergies?

Any anticipated adjustment concerns?

Any other information about your child or family you wish us to know

Child Release Information

No child may be released from the provider to any person other than his/her parents or other person(s) currently designated in writing by such parent to receive the child.

In the event your child has not been picked up by 3:00pm, and you cannot be reached, we will attempt to contact authorized people listed below.

The following person(s) have permission to pick up my child:

Person 1

Phone

Relationship to child

Person 2

Phone

Relationship to child

Person 3

Phone

Relationship to child

Person 4

Phone

Relationship to child

Thank you for registering! When finished, click "Submit," and we'll contact you soon!

*) Required fields

Little Tree Learners Registration Form

If neither parent or guardian can be reached in case of an emergency, please call

Medical Information

Feeding times

Nap Time

Other

*Please note that children entering the Pre-K 4/5 Class MUST be fully potty-trained*

Please give information that will be helpful to your child's teacher.

No child may be released from the provider to any person other than his/her parents or other person(s) currently designated in writing by such parent to receive the child.

In the event your child has not been picked up by 3:00pm, and you cannot be reached, we will attempt to contact authorized people listed below.

The following person(s) have permission to pick up my child:

Thank you for registering! When finished, click "Submit," and we'll contact you soon!

Please note that children entering the Pre-K 4/5 Class MUST be fully potty-trained