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Arizona PBS Kids Cocopah Super Why!
Get Ready for Kindergarten
Child Registration Form
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* Indicates required question
Child First Name
*
Your answer
Child Last Name
*
Your answer
Child Birthdate
*
MM
/
DD
/
YYYY
Parent/Guardian First Name
*
Your answer
Parent/Guardian Last Name
*
Your answer
Phone Number
*
Your answer
Are you able to receive text messages?
*
Yes
No
Email address
*
Your answer
Has your child previously attended Head Start or been in any other preschool setting?
*
Yes
No
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