*
Required
Summer Programs 2021: Lottery Registration
If you have any questions while completing this registration, please refer back to the
Summer Programs Page
on the website. You can also contact Mary Farmer at
mfarmer@ncrcpreschool.org
. If you are registering more than one child for camp, you must submit one form per child.
Child Information
NCRC Status
*
required
Please Select…
NCRC Student (Re-Enrollment Pending)
NCRC Student (Re-Enrolled)
New Student for the 2021/2022 School Year
Awaiting an NCRC Enrollment Contract
Last Name
*
required
Child's Preferred First Name
*
required
DOB
*
required
(mm/dd/yyyy)
Gender*
Male
Female
Summer Programs: Group Selection
Select Group
*
required
Please Select…
Primary Colors (Early Learning)
Secondary Colors (Preschool)
Tertiary Colors (Pre-Kindergarten)
Does your child have any special needs?*
Yes
No
If yes above, please share more information.
Contact Information
Parent/Guardian 1
Parent 1/Guardian 1 Name
*
required
Parent 1/Guardian 1 Phone(best to contact you)
*
required
Parent 1/Guardian 1 Email
*
required
Parent/Guardian 2
Parent 2/Guardian 2 Name
Parent 2/Guardian 2 Phone(best to contact you)
Parent 2/Guardian 2 Email
Address
Street Address
*
required
City
*
required
State
*
required
Zip
*
required
Please send a confirmation email to the address below*: