Full Name *

First Name

Last Name

Phone Number

(###)

###

####

Child’s Name *

First Name

Last Name

Which age groups are you interested in? *

Infant Room (0-12 months)

Toddler Room (12-24 months)

Preschool Room (2-3 years)

Pre-K Room (4-5 years)

Preferred Start Date

MM

DD

YYYY

What interests you most about Little Peaks Academy?

Check all that apply.

STEM Learning

Outdoor Activities

Sports & Movement

Class Sizes

Community & Family Engagement

Kindergarten Readiness

Before & Aftercare

Other (specify below)