Please enable JavaScript in your browser to complete this form.1. Please select a Date/Time you like to come (We will email you the confirmation) *Please contact me for SPECIAL Date/Time2. Student (Your Child's) Name *FirstLast3. Student (Your Child's) Sex *Male (Boy)Female (Girl)4. Student (Your Child's) Birth Date *5. Parent's Email *6. Parent's Cell Phone# *7. I am interested in 3K or 4K Program (FREE) -- Select ONLY ONE *Born in 2022 -- 3K (9-3:20pm)Born in 2021-- 4K (9-3:20pm)Born in 2021 -- EDY-4K (9-5:00pm -- Sept - June ) -- Small FEE --For Low Income FamilyOther (Please fill out Question #8)8. If NOT born in 2021 or 2020 (#7-Other), please tell us what year? 9. I am Interested Other Programs (FEE required--optional) After School PlayTime Class M-F 3:20-5:00pmAfter School Fun Learning Class M-F 3:20-5:00pm10. How do you hear about us? -- Select ONE or MORE *My Child is Currently attending IP KIDSMy older Child/Children attended IP KIDS in the pastReferred by my Friend or RelativeLiving near byGoogle Search Other11. Comment (Optional)Submit