Welcome.

Interested in your child attending The Rock Pre-K? Let us know some info about you and your child and we’ll be in touch as soon as possible.

Parent/Guardian Name

First Name

Last Name

Phone

(###)

###

####

Child's name (#1)

Child 1

First Name

Last Name

Date of birth

Child 1

YYYY

Gender

Child 1

Child's name (#2)

Child 2

First Name

Last Name

Date of birth

Child 2

YYYY

Gender

Child 2

Child's name (#3)

Child 3

First Name

Last Name

Date of birth

Child 3

YYYY

Gender

Child 3

Care needed by

YYYY

Currently in a childcare facility

What are the circumstances for which you need or are changing your childcare?

Preferred walkthrough date/time

We're open M-F, 7am-6pm

How did you hear about us?

Additional notes or questions: