RCC Preschool

Registration 2011
(print and submit to Sarah Lockett, Director)

  Child's Name _____________________________________________   Birthdate ______________________  

  Parent's Name ____________________________________________________________________________  

  Address _________________________________________________________________________________

  City __________________________________________  Zip Code _________________________________  

  Home Phone _________________________________    Cell Phone ________________________________

                                      Payment submitted with this form secures your spot for the fall.
                                                       No spots will be held without payment.

Registration Fee (non-refundable)                                             $30.00
Supply Fee                                                                                     25.00  

TOTAL DUE                                                                                $55.00

Check # _____________________

Thank you,
Sarah Lockett
Director
 rccpreschool@clearwire.net
254-662-1619