Registration Form

9 month academic school year: 3 Sept, 2019 - 22 May, 2020
There is a non-refundable registration fee of $100 due with the online Registration Form.
1. Complete online registration form and send the registration fee to
Kangaroo Preschool; 3157 Earlysville Rd, Earlysville, VA 22936.
2. You will receive an acceptance email to confirm registration for your child.
*Students must be toilet trained.

APPLICATION FORM

* Indicates required field

Child's Name *

First

Last

Select One *

Child's Date of Birth *

Telephone Number *

Address (# and street name) *

City, State, Zip *

Parents Name *

Parent's Email Address *

Selected Time *

kangapreschool@gmail.com

(434) 973-8736

Submit