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You can now register online to join our

Rascals, Rainbow and Rockies programs!

Program Preferences

I would like my child to attend on the following days: (*please note that exact dates can be chosen for Rocies at a later time)

Child's Information

Contact Information

Family Information

Emergency Contacts

Health History (chronic or recurring)
Attach Immunization Records

I hereby give Rainbow/Rascals/Rockies permission to call a doctor or emergency medical service and for the doctor, hospital, or medical service to provide emergency medical or surgical care for my child.

It is understood that the child care provider will make a conscientious effort to locate the parent/guardians and emergency contacts listed on the registration document before any action will be taken. If it is not possible to locate emergency contacts listed, treatment will not be delayed. I/we will accept the expense of emergency transportation, medical or surgical treatment. 

Except for gross or criminal negligence on the part of Rainbow/Rascals/Rockies, I assume all risks, which may be associated with participating in their program, and release, hold harmless, and indemnify Rainbow/Rascals/Rockies from responsibility for any occurrence, which may result in accident, injury, illness or harm of any kind to my child while he or she is in their care. 

Attach a copy of your driver's license

Parent/Guardian Signature


Please check each box to acknowledge your acceptance of the following terms.

I have read the registration packet in its entirety and understand Rainbow's policies and procedures.

I agree to allow Rainbow to obtain any medical attention for my child that they may think necessary at my expense.

I give my permission for my child to attend field trips with Rainbow. These will include walking trips, trips using the town shuttle and trips using the Rainbow bus.

I understand that it is my responsibility to sunscreen my child thoroughly every day and I give Rainbow permission to do touch up sunscreen on my child. Rainbow uses Alba SPF 45.

In case of small claims action, I agree to venue in San Miguel County.

I understand that Rainbow's earliest drop off time is 7:45am and latest pick up time is 5:15pm. I will respect these times and agree to pay $1/minute that my child is at Rainbow after 5:30pm. I also understand that I am required to arrive at Rainbow before 9am or wait until after 10am. 

I understand that I am required to leave Rainbow instructions on how I can be reached at all times. If my phone numbers or plans change, I will notify Rainbow. 

I agree to have Rainbow/Rascals/Rockies use my credit card on file to pay my bill if it is over 60 days overdue. 

I understand that in order to enroll in the Rainbow/Rascals/Rockies program, I will be billed $150 (15 tickets at $10 each) for the Fall Fundraiser raffle tickets. I can sell these raffle tickets to recoup this money or I can keep them for myself. Please see registration packet for more details on the Fall Fundraiser. 

Parent/Guardian Signature

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