"R.E.L. Kids Learning thru Real Play!" ©
“You can discover more about a person in an hour of play than in a year of conversation.”- Plato
Forms & Links
Our PTA Club
Child Care Needs Survey
*Name of Child #1 and DOB
Name of Child #2 and DOB
Name of Child #3 and DOB
Name of Child #4 and DOB
*Any allergies, health or behavioral issues we need to be aware of for any child? If so which child and the issue?
*Is the child(ren) on any medication? prescribed or over the counter? If so what kind and can it be given outside of preschool hours or can you have someone administer the medication?
*List any child that needs assistance with toileting.
*What days do you need childcare?
*What hours do you need childcare?
*What centers, childcare, preschool did your child(ren) attended in the past 5 years. Name of company, Reason for leaving, Phone Number, Start date and end date. Please make sure you provide all info requested.
*Main Phone No.
*2nd Phone No.
I verify the information provided concerning my child’s application is true. I also understand if any information was false, Rainbow Early Learning has the right to expel my child from the program without any explanation. I understand the
per child and it is non-refundable. I understand this application will not be submitted until all application fees has been paid in full at the time of submission. If fees has not been paid, then a new application must be filled out. I also am aware and agree to having Rainbow Early Learning, Inc. perform a background check on myself and those I give permission to pick up my child(ren). I understand this is for the safety of all children in their care and only seeks crimes against children. I will hold harmless Rainbow Early Learning, Inc., its representatives and/ or its staff from any liability which may arise from this background check on the information indicated above or falsification of this application. This application is not a guarantee of acceptance to the program. I understand I may be required to fill out more paperwork before a final decision is made
whether my child(ren) is accepted to the program. I understand once I click on the submit button, I agree to these terms, any amendments and those in the parent handbook.
*Electronic Signature of Person completing this form.
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