Parent Questionnaire
Parent's Name
Child's name
What are your child's interests and what do they like to play with?
Phone number (in case of an emergency)
Child's birthdate
Do you have any other comments or questions?
Does your child have ANY allergies (if none, please state none)
What fears does your child have?
Does your child nap in the afternoon?
Are you concerned about any areas of your child's development?
What foods does your child dislike?
Is your child toilet trained?
Will you be staying during the class?
Submit