Registration

Child's Name
First Last
Date of Birth

MM/DD/YYYY
Application for (school year)
Semester
Have you spoken to a Nest representative?
If so, let us know here what was discussed?
How did you hear about The Nest?
Previous preschool history
If Yes, how many years
Does your child attend recreation or play dates where the parent is not present?
Describe how your child responds to separation from parents.
Parent 1
First Last
Relationship to child
Email
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Parent 2
First Last
Email
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Parents are
Child lives with

Guardian or other designated person who may pick up or drop off your child may be added to our Brightwheel app after your child’s placement is confirmed.
Your child’s doctor
First Last
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Allergies
Additional Emergency Contact
First Last
Phone
Request to schedule appointment for
Date
MM slash DD slash YYYY
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