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Little Rock Stars CR North Preschool Enrollment 2022-23
Please complete 1 form per child.
This form is for the 2022-2023 year.
Please read all program information on our website before signing up:
https://sites.google.com/crsd.org/rockstars/home
Questions?
Email Ms. Back:
rback@crsd.org
* Indicates required question
First Name of Child
*
Your answer
Last Name of Child
*
Your answer
Child's nick name if any ex: Nick instead of Nicholas
Your answer
Age as of September 15th, 2022
*
Your answer
Birthdate
*
MM
/
DD
/
YYYY
Is your child toilet trained?
*
Yes
No
Parent/Guardian Contact Full Name
*
Your answer
Parent/Guardian Contact Phone Number
*
Your answer
Parent/Guardian Contact Email
*
Your answer
Address
*
Your answer
Emergency Contact Full Name
*
Your answer
Emergency Contact Phone Number
*
Your answer
Emergency Contact Email
*
Your answer
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