Register – Cathedral Preschool

Student Name*
First Middle Last
Preferred Name
The name by which your child should be addressed while at school.
Date of Birth*
We use the student's date of birth to provide a list of available programs.
Month
Day
Year
Registration Type*
Specify whether your child will be a *new* student at Cathedral Preschool for the upcoming school year (2022-23), or if they are currently enrolled for this year (2021-22) and are *returning.* [If you are the family of a current student but this is a registration for a new student, like a younger sibling, please select "New" so we can get complete information on the new student.]
- New Cathedral Preschool Student
- Returning Cathedral Preschool Student
Returning Student Primary Contact Email*

Program Selection
Please select your program choices. A student may only be enrolled in WrapAround Care on the days they attend morning preschool class.
First Choice*
There are no suitable programs based on the date of birth provided.

Second Choice
There are no suitable programs based on the date of birth provided.
Special Consideration
We do our absolute best to accommodate. Please help us by providing factors we should consider when placing the student in the Preschool-only Class or Preschool with WrapAround Care Class. For example, carpooling with another student, or your student can only attend on specific days, or you wish to enroll your child in a Preschool with WrapAround Class but the child will not stay for WrapAround on all of the days listed for that class (for instance, you want the 4-day Preschool Class but only two days WrapAround Care.)
Kindergarten Plans
Will your student likely be attending kindergarten next school year? [This will help us in determining class placement for those children whose birthdate makes them eligible to attend kindergarten year after next, but who fall in that "gray area" when many parents plan to wait another year.]
- Yes
- No
- Not sure / Depends on how upcoming school year goes
- N/A - too young anyway

Student Information
Gender, School Experience, Address
Gender*
- Female
- Male
Previous School Experience*
- Yes
- No
Previous School Experience Details*
Understanding the previous school experience of the student helps to ensure proper placement in the program.
- Traditional daycare
- Non-parental In-home Daycare
- Parents' Day Out
- Preschool
Address*
The primary address where the student resides.

Street Address Address Line 2 City State ZIP Code

Family Information
Please provide at least one contact. Email and cellphone information are required for setup of Brightwheel app for communication and billing. (Later on, you will be able to provide contact information in Brightwheel for any other authorized contacts who may be checking your child in and out of school.)
Primary Contact
Our first point of contact.
Name*
First Last
Relationship to Student
Email*
Phone*
Same Address as Student?*
- Yes
- No
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Secondary Contact
Our point of contact should the Primary Contact be unavailable.
Name*
First Last
Relationship to Student
Email
Phone*
Contact 2 Same Address as Student?*
The secondary contact lives in the same household as the student.
- Yes
- No
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Names & Ages of Siblings
First Last Age

Immunization Certificate
A copy of a current Kentucky immunization certificate is required for the student to attend preschool or care programs.
Immunization Certificate*
- Upload here
- Fax to (270)683-3621
Upload Immunization Certificate*
Accepted file types: pdf, jpg, png, Max. file size: 50 MB.
Please note that we will not proceed with your student's registration until the immunization certificate is received.
Primary Care Physician
Provide contact information about the primary care physician of the student.
Name*
First Last
Phone*
Medical/Allergies
Food Allergies*
The student has food allergies.
- Yes
- No
Food Allergy Details*
Identify all the foods the student should avoid due to allergies.
- Eggs
- Peanuts
- Tree Nuts
- Milk/Dairy
- Other
Food Allergies Explanation*
Provide any explanation regarding the student's food allergies if necessary.
Foods to be Avoided
Please list specific foods that should not be served to the student due to dietary restrictions or sensitivities. These are foods that are not an actual food allergy the student may have. For example: "Avoid milk due to constipation."
Other Medical Conditions
Please briefly explain any medical condition that the school would need to be aware of, such as asthma requiring inhaler, allergy to bee stings, chronic seasonal allergies, etc. Further information may be requested if necessary after enrollment before school begins.
Untitled
Name
This field is for validation purposes and should be left unchanged.

First	Last	Age

Program Selection