Enroll Online Summer Childcare : St. Mark Preschool & Childcare

Sibling 1 Name
Sibling 1 Date of Birth
MM slash DD slash YYYY
Sibling 2 Name
Sibling 2 Date of Birth
MM slash DD slash YYYY
Sibling 3 Name
Sibling 3 Date of Birth
MM slash DD slash YYYY
Sibling 4 Name
Sibling 4 Date of Birth
MM slash DD slash YYYY
Sibling 5 Name
Sibling 5 Date of Birth
MM slash DD slash YYYY
Is child right-handed or left-handed?*
- Right-handed
- Left-handed
Please list any allergies, medical concerns, or other information we need to know about your child:*
Present place of active church membership
Name of Pastor or Priest
Has your child been baptized?*
- Yes
- No
Date of baptism
MM slash DD slash YYYY

Enrolling in Summer Childcare