Child's name *
Child's name
Child's birthdate
Child's birthdate
Phone (Home) *
Phone (Home)
Cell phone for parent/guardian 1 *
Cell phone for parent/guardian 1
Cell phone for parent/guardian 2
Cell phone for parent/guardian 2
Preferred days: *
Check all that apply.
Session/s interested in:
Check all that apply.

Please submit this form and send a $75 non-refundable deposit for fall registration to:

St. Mark’s Nursery School

451 Moraga Way
Orinda, CA 94563

When this form and the non-refundable deposit are received, you will receive a confirmation letter or email and your child’s name will be placed on the waiting list. The postmark date will determine your position on the list.