Date

Child's Name *

First

Last

GenderMaleFemale

Age *

Birthdate *

Address

City / Postal Code

Parent Name *

First

Last

Occupation *

First

Last

Cell Phone

Business Address

Business Tel.

Email *

Sibling(s) Names with Birthdates

Name of Sibling(s) Who Has Attended Hillcrest J.K. in The Past 5 Years (2018-2022)

Sibling(s) year of Birth

Program

• Toddler Program (Morning: 9am – 12:30pm)
• Toddler Program (Full Day: 9am – 3:30pm)
• Nursery Program (Morning: 9am – 12:30pm)
• Nursery Program (Full Day: 9am – 3:30pm)
• Junior Kindergarten (Full Day: 9am – 3:30pm)
• Senior Kindergarten (Full Day: 9am – 3:30pm)

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