Kings Early Years Screening for School Registration (Registration begins in the spring of 2010)
Parent/Guardian(s)
PO Box
Street
Town
Postal Code
Home Phone
Alternative Phone
Child's Name
Child's Date of Birth Sex Male Female
School to Attend in 2012 School NameAldershotCambridgeColdbrookGlooscapKings County AcademyKingstonPort Williams Wolfville Other
Does your child have any current medical problems? Yes No
If so, please explain
Does your child have any allergies? Yes No
Has your child been to a professional for any of the following?
Vision Hearing
Dental Behavior
Speech Development
Are there any issues relevant to your child's development that you would like to see more information on? Any questions or concerns?