King's Kids Learning Center Enrollment Form

Please fill out the following form.

Child's Name

First name

Last name

Middle Initial

Child's Nickname

Child's Birthdate

Birth City and State

Existing medical conditions, medications and/or special attention your child may require.

Allergies, special health or medical conditions, and food supplements.Plan" or equivalent form and/ or the JFS 01217 "Request for Administration of Medication" must be completed and be kept on file at the center.

If yes to the previous questions. Explain

Additional Comments and Information

Parent/Legal Guardian Signature

Your Signature

Thanks for submitting!

821 S. Kirkman Rd.
Orlando, Fl. 32811
407.287.6627

telephone:

King's Kids Learning Center Enrollment Form

Child's Name

Parent/Legal Guardian Signature

King's Kids Learning Center Enrollment Form

Child's Name

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Parent/Legal Guardian Signature