Child's Name:

Child's Name

Date of birth (D.O.B.):

Parent’s Name:

Cell Number:

Address:

Email:

Your child will be enrolling in the following program:

PK1PK2PK3PK4Kindergarten

Your child will be enrolling in the following schedule

Half DayFull DayExtended Hours

Length of enrollment

Has your child attended to Baby Stars Grownup and Me?:

yesno

If yes, how long?

Less than 3 months3 to 6 monthsOver 6 months

Has your child attended preschool before?