RBCS Family Application
Name of Parent Completing Form
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Child's Name
*
First Name
Last Name
Name child will use at school, if different than first name
Child's Date of Birth
*
-
Month
-
Day
Year
Date
Child's Age as of Today
*
Child's Gender
*
Please Select
Male
Female
Is child potty trained?
*
Please Select
Yes
No
Not fully, but currently working on it.
Desired Start Date
*
1st Preference in Schedule
*
M-F (all ages)
M-Th (3 & 4 year olds only)
MWF (2 years & younger only)
TTh (2 years & younger only)
2nd Preference in Schedule
M-F
M-Th
MWF
TTh
Complete if you have a 2nd child to add to your application.
2nd Child's Name
First Name
Last Name
Name 2nd child will use at school, if different than first name
2nd Child's Date of Birth
-
Month
-
Day
Year
Date
2nd Child's Age as of Today
2nd Child's Gender
Please Select
Male
Female
Is 2nd child potty trained?
Please Select
Yes
No
Not fully, but currently working on it.
Desired Start Date
1st Preference in Schedule
M-F (all ages)
M-Th (3 & 4 year olds only)
MWF (2 years & younger only)
TTh (2 years & younger only)
2nd Preference in Schedule
M-F
M-Th
MWF
TTh
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Are you members of Riverbend Church?
*
Please Select
Yes
No
No, but we attend.
Did other children in your family attend RBCS?
*
Please Select
Yes
No
If other children have attended, please list their name(s).
Please tell us how you heard about RBCS.
*
Please Select
Referred
RiverKIDS/Riverbend Church
Austin Kid's Directory
Facebook
Community Impact
Other or Unsure
If someone referred you to our program, please let us know who we can thank.
Have you had an opportunity to tour the school?
*
Please Select
Yes
No
Any other comments or details you would like to share about your application?
With your signature, you are submitting this application on behalf of your child(ren) and acknowledge you have read and understand the Application & Waitlist policies of RBCS.
*
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RBCS Family Application
Non-refundable Application Fee Fee will apply toward registration fee should you register at RBCS in the future.
$
100.00
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
Submit
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