Kindergarten Pre Registration 2022
Child must be 5 years old on or before August 15, 2022.
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Child's Full Name *
Child's Date of Birth *
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Child's Gender *
Primary Contact's Name and Relationship (mother, father, guardian, etc.) *
Primary Contact's Phone Number *
Primary Contact's Email *
Current Moore County Address (Child must reside at the address.)  Parent/Guardian will be required to provide TWO proofs of residency, one must be driver's license with current Moore County address.   Someone will contact you for these. *
In addition to parent/guardian's driver's license with current Moore County address, please choose which additional proof of residency you will provide prior to your child's testing date in May.  Someone will contact you for these. *
Mother's name *
Mother's primary phone number *
Father's name *
Father's primary phone number *
Does your child have any siblings who attend Lynchburg Elementary or Moore County High School?  If so, what are their names? *
Are there any custody issues at this time?  If yes, please provide the name and phone number of child's legal guardian.  (The school will also require a copy of current custody papers.) *
Has your child ever attended a Pre K, daycare, or head start program?  If so, which one? *
Does your child currently receive any of these services? *
Required
Please list any medical issues of which we need to be aware. *
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