Register my child

You can register your child by downloading this form (PDF) or fill out the form online:

Pre-school Child's FULL Name
Child's Date of Birth Gender of child: Male Female

Parent/Guardian's Name
Email Phone

Child's Home Address:
City State ZIP

Child's Mailing Address (if different):
City State ZIP

By checking this box, I attest that this child is a resident of Rock Island or Scott counties.


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