Registration Form - Friedens Early Learning Academy (FELA) 2014-15
2555 Friedens Church Road, Seguin Texas 78155. 830-303-7729. www.friedensearlylearningacademy.org
CHILD’S NAME: __________________________ BIRTHDATE: _________________
Home Address: ________________________ City/Zip:_________________________
Home Phone: ____________________________ Admission Date:_________________
E-Mail Address:______________________________________ Work email_____________________
MOTHER/GUARDIAN Name: Employer: Work Phone: Cell: Driver’s License #:
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FATHER/GUARDIAN Name: Employer: Work Phone: Cell: Driver’s License #: |
One contact, other than the parents, is required for registration. If the parents are unavailable, the following individual has permission to transport and seek care for this child.
Name Drivers License# Address Phone (work/home/cell)
_________________________________________________________________________________________________
The following people are only authorized to pick up this child.
Name/Address Driver’s License# Phone (work/home/cell)
_______________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
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My child is normally in care on the following days and times: |