Caterpillar Registration - Lehi Preschool

Caterpillar Registration
4 year olds

Schedule: 11:45am – 2:15pm, Monday, Wednesday, and Friday

Tuition: $100 per month
Student Information
Full Name

First NameLast Name
Gender
Birth Date

MonthDayYear
Favorite Food
Favorite Color
Favorite Activity
Dominant Hand
Number of Siblings
Position Among Siblings
About your child
How do they learn best, what is their personality like, your concerns, etc.
Allergies or Special Concerns

Parent Information
Parent 1

First NameLast Name
Daytime Phone
Format: (000) 000-0000.
E-mail
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent 2

First NameLast Name
Daytime Phone
Format: (000) 000-0000.
E-mail
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Emergency Information
Emergency Contact

First NameLast Name
Phone Number
Format: (000) 000-0000.
Doctor

First NameLast Name
Phone Number
Format: (000) 000-0000.
Dentist

First NameLast Name
Phone Number
Format: (000) 000-0000.
Insurance Information
Should be Empty: