Join Yuma Pre-School

Child's Name is required
Child's Birth month is required
Child's Birth day is required
Child's Birth year is required
Address is required
Zip is required
Home Phone is required
E-mail Address is required
Father's Name is required
Father's Birth month is required
Father's Birth day is required
Father's Birth year is required
Father's Employer is required
Father's Cell Phone is required
Mother's Name is required
Mother's Birth month is required
Mother's Birth day is required
Mother's Birth year is required
Mother's Employer is required
Mother's Cell Phone is required
Marital Status is required
How Many Children is required
Ages are required
Languages Spoken is required
Does Your Child Eat Well is required
Does Your Child Take Naps is required
How Long is required
Words Spoken or Action Taken When Your Child Disobeys is required
Do You Think Your Child Will Function Well at The School is required
How Did You Hear About Us is required
How Did You Contact Us is required

In Case of Emergency and Parents Cannot Be Reached Call:
THIS INFORMATION MUST BE CURRENT. PLEASE NO OUT OF TOWN NUMBERS.

Emergency Name is required
Emergency Phone is required
Emergency Name is required
Emergency Phone is required

Individuals you give permission to pickup your child will be asked for proper identification.

Emergency Approval is required
Media Approval is required

Yuma Pre-School Carries Liability Insurance.

Parent Signature is required

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