Please Fill Out This Form

Register your child into Preschool Club by filling out the form below.

Child Full Name *

Address *

Street Address

City

State

Country

Postal Code

Child Date of Birth *

Child Gender *

Male

Female

Child 1 T-Shirt Size *

Child XS / 2T

Child S / 3T

Child M / 4T

Child L / 5T

What are your child's hobbies / interests? *

What do you hope your child will gain by attending Little Sprouts Preschool? *

What concerns (if any) do you currently have about your child's academic development? *

What type of device will your child use to view and engage in Preschool Club? *

Cellphone

Laptop

Tablet / iPad

Does your child have any conditions that will affect play/learning? Please type YES or NO. If YES, please list conditions. *

Upload a clear headshot of your little sprout here! See samples below.

Example Headshot Photo #1

Example Headshot Photo #2

Child 1 Photo *

Child 1 Photo

JPEG, JPG or PNG

Please enter YOUR information below.

(This should be the information for the legal parent/guardian of the child.)

Authorized Adult 1 Full Name *

Email *

Authorized Adult 1 Phone *

(Compliance) Text Checkbox

I Consent to Receive SMS Notifications, Alerts & Upcoming Appointment Details from Little Sprouts Learn and Play Preschool Message frequency may vary. Message & data rates may apply. Text HELP for assistance. You may reply STOP to unsubscribe at any time.

I Consent to Receive the Occasional Marketing Messages from Little Sprouts Learn and Play Preschool. You may Reply STOP to unsubscribe at any time.

Please enter second parent information below.

(This should be the information for the legal parent/guardian of the child.)

2nd Parent Full Name *

Email Address (Parent 2) *

2nd Parent Phone *

(Compliance) Text Checkbox (copy) *

I Consent to Receive SMS Notifications, Alerts & Upcoming Appointment Details from Little Sprouts Learn and Play Preschool Message frequency may vary. Message & data rates may apply. Text HELP for assistance. You may reply STOP to unsubscribe at any time.

I Consent to Receive the Occasional Marketing Messages from Little Sprouts Learn and Play Preschool. You may Reply STOP to unsubscribe at any time.

To keep our online preschool running smoothly, please agree to all of these policies:

I understand that after signing up, I will receive an email within 24 hours (but usually immediately) with access to the Preschool Club member's area, and I will find resources there on how Preschool Club runs. I understand that I can cancel anytime.

Parent Agreement *

I understand that Little Sprouts Learn & Play Preschool is a faith-based program (specifically Christian) and that students will engage in activities containing prayer and scripture.

Parent Signature *

Clear

Date Signed *