2025-2026 Trinity Preschool, Inc. Registration Form

All students in our 3 & 4 year old program must be fully potty trained.

*Students who are fully potty trained:
- no longer need to wear pull ups...
- they are able to recognize & communicate the need to use the restroom...
- they are able to access & use the toiliet with little to no help...

We will help with wiping if they ask/need us.

Physical Address:
2411 Hwy 29 North
Danielsville Ga 30633

Today's Date

Childs Name

Childs Date of Birth

Age as of Sept. 1st

Gender

Male Female

Will your child go to Kindergarten next fall?

Yes No

Physical Address

Mailing Address (If different from physical)

Parent/Guardian 1 Name (First & Last)

Parent/Guardian 1 Cell #

Home Phone (If different from cell)

Parent/Guardian 1 Occupation

Parent/Guardian 1 Business #

Parent/Guardian 1 Email

Parent/Guardian 2 Name (First & Last)

Address (If different from Parent/Guardian 1)

Parent/Guardian 2 Cell #

Home Phone (If different from cell)

Parent/Guardian 2 Occupation

Parent/Guardian 2 Business #

Parent/Guardian 2 Email

Siblings:

Where does your family attend church?

Authorized To Pick Up Your Child:

Please list anyone other than you and/or your spouse.

Name

Phone #

Name

Phone #

Name

Phone #

Name

Phone #

Name

Phone #

Name

Phone #

Emergency Information

Child's Pediatrician

Pediatrician's Number

Person(s) authorized to act as parent(s) in an emergency:

Name

Address

Phone

Name

Address

Phone

Media Release Form

Trinity Preschool, Inc. has my permission to take photographs and/or videos of my child, and to use those photos/videos for the purposes of promoting Trinity Preschool, Inc. programs?

Select one:

Yes No

Health Information

Is your child allergic to anything?

Yes No

If yes, please explain:

Does your child have any medical concerns we need to be aware of?

Yes No

If yes, please explain:

Do you have any concerns with the following?

Hearing Speech Vision None

Does your child have any other concerns we need to be aware of?

Yes No

If yes, please explain:

Notice of Exemption

I acknowledge that I have been informed:
- This program is 4 hours or less each day...
- Is not required to be licensed by the Georgia Department of Early Care and Learning...
- This program is exempt from state licensure requirements, but is registered with Bright From The Start...

Electronic Signature

* Please submit one form per child.

* The $150.00 non-refundable registration fee per child is required to be paid within 7 days after you complete this form. This fee will cover all supplies for the school year. (You do not have to pay the fee if you are on the wait list) You can mail a check to the address listed above or call to make arrangements.

* If Parents are separted or divorced, please make sure all legal actions are handled and all information listed above is correct. Trinity Preschool will not get involved in any custody issues unless the child is in danger and you provide a TPO. In this case we will make sure we protect your child from anyone that is a threat to them.

*By submitting and signing this form, you agree to abide by all of The Parental Policies and Procedures of Trinity Preschool and understand the notice of exemption.

* I certify that I am the parent or legal guardian of the above minor and confirm that the information I entered is accurate and true.
* I am at least 18 years old and I have read and agree to the terms of the above agreement.
* By typing my full name below, I am electronically certifying this waiver document just as if I would physically sign it if it was on paper.

Date:

Parent Signature:

2025-2026 Trinity Preschool, Inc. Registration Form

Description

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