Lil Highlander Preschool
at McKean High School
Child Information Card
Child’s Full Name ________________________________________________________
M_____F_____
Date of Birth__________________________________
Name you prefer your child to be called in school:_______________________________
Name of Parent/Guardian:
Name of Parent/Guardian:
Relationship to Child:
Address:
Relationship to Child:
Address:
Home Phone #:
Home Phone #:
Cell Phone #:
Cell Phone #
Place of Employment:
Place of Employment:
Occupation:
Occupation:
Work Phone #:
Work Phone #:
Email:
Email:
Status of Parents: (check all that apply) ___Living Together ___Living Separately
___Married
___Divorced
Child Lives with: (List all names of people living in household and relationship to child. If sibling list
age)
Persons other than parent/guardian authorized by you to pick up your child (Photo
Identification with name and address will be required of them). List in order of preferred
contact:
Name
Address
Relationship to Child
Lil Highlander Preschool
at McKean High School
Physical Development and Background
Child’s Pediatrician________________________________ Phone __________________
Has your child had any serious illnesses, accidents or hospital experiences?__________
If so, please list:__________________________________________________________
Known Drug/Environmental Allergies:________________________________________
(please indicate no known allergies if applicable)
Known Food Allergies:_____________________________________________________
(please indicate no known allergies if applicable)
Please attach doctor’s note and food allergy action plan if your child has one.
[ ] Consent for posting child’s allergy information, including no known allergies
(please print)
I, ____________________________, the parent or legal guardian of ________________,
who is my minor child, hereby authorize the Lil Highlanders Preschool staff to post my
child’s food allergu information in order to protect my child from contact with these
foods.
Signature
Does your child have any physical limitations, injuries, illnesses, or health issues which
would limit his/her participation in the full range of school activities? If so, please
describe:________________________________________________________________
_______________________________________________________________________
Lil Highlander Preschool
at McKean High School
Child Interests
What activities does your child enjoy with siblings? _____________________________
mother___________________________
father________________________________
Other children outside your family___________________________________________
What type of play would you describe as being your child’s favorite?
_______________________________________________________________________
Least favorite?____________________________________________________________
What are your child’s favorite snack foods?_____________________________________
Least favorite?____________________________________________________________
Are there any foods you would like your child to try that he or she has been reluctant to
try?
________________________________________________________________________
Has your child ever been in a play group or other school situation away from you?______
What would you like your child to get out of this preschool experience?______________
________________________________________________________________________
What additional information would you like us to know?__________________________
________________________________________________________________________
Lil Highlander Preschool
at McKean High School
\
Additional Information Required
The following items must be received before your child can begin preschool:
 Current (less than 1 year old) Child Health Appraisal
 Field Trip Authorization
 Deposit $20 (to be applied toward first month’s tuition)
Contact Information
Lisa Gonzon
Thomas McKean High School
301 McKennan’s Church Road
Wilmington Delaware
[email protected]
302-992-1949
Lil Highlander Preschool
at McKean High School
Field Trip Authorization
Lil Highlander Preschool
McKean High School
301 McKennan’s Church Road
Wilmington DE 19808
I hereby consent to have my/our children participate in field trips supervised by the
teaching staff, on the grounds of McKean High School. I will be notified through the
weekly newsletter of any field trips.
.
Child’s Name (please print) ________________________________________
Parent’s signature______________________________________________
Date____________