GCS Admission Form

Student Information
Child's First Name*
Child's Last Name*
Has your child previously attended Grapevine Christian School?*

YesNo
How did you hear about Grapevine Christian School?
What name does your child go by, if different from above ?
What name would you like on your child's school supplies and mementos ?*
Gender*

FemaleMale
Date of Birth*

MonthDayYear
Date
Language spoken at home*
T-Shirt Size*
Class Option (Choose the preferred days you wish for your child to attend, or for Transitional Kindergarten choose TK, which meets 5 days.)*
Class Option: In the event there is not space in your preferred class, would you consider a different class? If so, which class would be your second choice?
PLEASE NOTE: We will contact you to confirm availability in your preferred class. If we do NOT have availability in your preferred class, you will be placed on our waiting list.
Is your child potty trained?*

NoYes
PLEASE NOTE: Children in our 3 year old classes should be ACTIVELY working on potty training or FULLY potty trained PRIOR to beginning school at GCS. Children in our Pre K and Transitional Kindergarten classes should be FULLY potty trained.
Does your child attend church regularly?*

YesNo
Name of church
Child's Street Address*
Child's Street Address Line 2
City*
State*
Zip Code*
Primary Parent/Legal Guardian

The parent/legal guardian listed here will be our first contact.
First Name (Parent/Guardian 1)*
Last Name (Parent/Guardian 1)*
Relationship to student (Parent/Guardian 1)*
Daytime Phone (Parent/Guardian 1)*
E-mail (Parent/Guardian 1)*
example@example.com
Additional Parent/ Legal Guardian Information

The person listed here will be the second person we contact.
First Name (Parent/Guardian 2)
Last Name (Parent/Guardian 2)
Relationship to student (Parent/Guardian 2)
Daytime Phone (Parent/Guardian 2)
E-mail (Parent/Guardian 2)
example@example.com

Emergency Contact

While parents are always the first to be contacted in the case of an emergency, please provide the name, address, and phone number of the person to be called if parents cannot be reached during an emergency.
First Name (Emergency Contact)*
Last Name (Emergency Contact)*
Relationship to student (Emergency Contact)*
Daytime Phone (Emergency Contact)*
Street Address (Emergency Contact)*
Street Address Line 2 (Emergency Contact)
City (Emergency Contact)*
State (Emergency Contact)*
Zip Code (Emergency Contact)*
In addition to the parents and emergency contact listed above, I would like to authorize GCS to allow my child to leave the operation with additional person(s), which I will list below, if applicable.*

YesNo
Authorized Pick Up Person #1

Complete ALL information.
First Name
Last Name
Relationship to student
Daytime Phone
Authorized Pick Up Person #2

Complete ALL information.
First Name
Last Name
Relationship to student
Daytime Phone
Authorized Pick Up Person #3

Complete ALL information.
First Name
Last Name
Relationship to student
Daytime Phone
Signature*

We want to make sure you feel informed and empowered when it comes to your child’s care. The following list outlines important rights you have under Chapter 42 of the Human Resource Code (HRC) Section 42.04271.
- As a parent or guardian of a child in our care, you have the right to:Visit and check out the facility anytime during business hours—no need for advance notice!
- Access publicly available records about the facility.
- Receive inspection reports and learn how to view our compliance history online.
- Request a copy of our policies and procedures.
- Review staff training records and the training materials we use.
- Look at any written records we keep about your child.
- View any available video recordings related to an alleged incident involving your child (with privacy considerations for other children).
- Ensure we follow any court orders regarding visitation or custody.
- Get contact details for your local Child Care Regulation office.
- File a complaint with the local Child Care Regulation office if needed.
- Exercise your rights without fear of retaliation.
By signing below, you’re confirming that you’ve received a copy of these rights. We’re here to provide a safe and supportive environment for your child, and we appreciate the trust you place in us!
Signature

Clear

Registration Fee

I understand that in addition to the Admission Form I must submit a non-refundable registration fee to the GCS office in order to reserve a spot for my child in the preschool program. My child's spot in the program will NOT be reserved until both items have been received. An invoice will be sent via email to me through Brightwheel, the billing app GCS uses. Payment must be received within 48 hours of the invoice being sent in order for my child's spot to be secured.
2 Days (Tuesday/Thursday) - $200

3 Days (Monday/Wednesday/Friday) - $240

5 Days - $290
Should be Empty:

Student Information

Primary Parent/Legal Guardian

Additional Parent/ Legal Guardian Information

Emergency Contact

Authorized Pick Up Person #1

Authorized Pick Up Person #2

Authorized Pick Up Person #3

Student Medical Information

Registration Fee