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Where the river flows life abounds. Ezekiel 47:9

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UP RIVER FRIENDS' PRESCHOOL INTEREST LIST

Parent's full name*

Child's full name*

Phone*

Email*

Child's Gender*

Male

Female

County*

PERQUIMANS

GATES

Other

Address*

Child's Birthday*

Month

Day

Year

Age as of August 31*

2 years

3 years

4 years

Other

Interest in enrollment for *

School Year 2026-2027

School Year 2027-2028

School Year 2028-2029

Other

Allergies/Medical Conditions*

Are your child's immunizations currently up-to-date or will they be prior to starting preschool?*

Yes

No

Is your child currently potty trained?*

Yes

No

Are you currently enrolled or seeking enrollment elsewhere?*

Yes

No

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