Academic Year

Please provide a valid academic year from.
Please provide a valid academic year to.
Please provide a valid what would be your ideal start date?.

Child Information

Child's Name

First Name is required.
Middle Name is required.
Last Name is required.
Please provide a valid date of birth.
Place of Birth is required.
Family Mail Address is required.
City is required.
Zip Code is required.
GUARDIAN 1
Required
Relationship
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Name
Guardian 1 First Name is required.
Guardian 1 Last Name is required.
Contact
Guardian 1 Cell Number is required.
Please provide a valid guardian 1 email address.
Guardian 1 Home Phone Number is required.
Work
Guardian 1 Employer is required.
Guardian 1 Business Number is required.
GUARDIAN 2
Optional
Relationship
Please select an option.
Name
Guardian 2 First Name is required.
Guardian 2 Last Name is required.
Contact
Guardian 2 Cell Number is required.
Please provide a valid guardian 2 email address.
Guardian 2 Home Phone Number is required.
Work
Guardian 2 Employer is required.
Guardian 2 Business Number is required.

Language

Please select an option.
Please select an option.
What is the first language spoken at home? is required.
What is the second language spoken at home, if any? is required.

Emergency Contact

In case of an emergency, who can we call if we are unable to reach you

Name is required.
Telephone is required.
Family Mail Address is required.
City is required.
Zip Code is required.
Emergency Doctor's Name is required.
Emergency Doctor's Phone is required.

Academic Year Schedule

PLEASE CHOOSE BELOW A SCHEDULE AND TIME FOR THE ACADEMIC YEAR, SEPTEMBER - JUNE

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Medical Statements and Consent

Les Etoiles Preschool is not permitted to administer any medication, if needed, please do so at home or after school.
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Parent Initials is required.
Please enter a valid list any allergies your child has, or medical conditions, seizures, asthma, handicap, he/she has.
Note: All allergies/medical conditions must be stated on the child's medical form. Additionally, a "Standing Order" from the Pediatrician will be required in order to administer an Epi-Pen, Benadryl, or any Asthma medication. Your child will not be admitted without it.
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New York department of health requires that all children are vaccinated for school entrance.
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Additional Information

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Please select at least one option.
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Please enter a valid please feel free to include any relevant details..

Select a country first.