Date:
Childs Name:
Age:
DOB:

Street Address:
City:  State:  ZIP:
Home Phone:
M: F:

Mother:  Day Phone:
Father:  Day Phone:

Siblings & Age:
Email:
Church Affiliate (if any):

Check for class registration

Curious Twos: 
M/W Tue

Seeker Threes:
M/W  Tue

Explorer Fours:
M/W/TH 

Voyager Fives (Pre-K)
M/T/W/TH

Please send a $50 non-refundable registration fee. Make your check payable to John Knox Community Preschool. If you have any questions please call Caroline Burton at: 206.241.1606 x #34