Fall 2023 Learning Together Class Application (Parents with Children 12-24 months old)

Please complete and submit this form to apply for enrollment in our class for parents and children, ages 12-24 months old. In this class, you and your child will explore developmental activities, learn songs and rhymes and discover new skills and strategies to stimulate growth and development in your toddler. This class is offered on Tuesdays or Wednesdays, September 12, 2023 through December 6, 2023. The cost is $180.00 for the entire 12 week session. Payment is due June 15, 2023--cash or checks (payable to RBCPC Preschool) are accepted. Thank you!

Child's First Name *

Child's Last Name *

What is your first choice for a class time? *

Tuesdays 9:00 a.m. - 10:00 a.m.

Wednesdays 9:00 a.m. - 10:00 a.m.

Wednesdays 10:30 a.m. - 11:30 a.m.

What is your second choice for a class time? *

Tuesdays 9:00 a.m. - 10:00 a.m.

Wednesdays 9:00 a.m. - 10:00 a.m.

Wednesdays 10:30 a.m. - 11:30 a.m.

Child's Gender *

Male

Female

Your Child's birth date? +

Parent #1/Guardian #1 First Name *

Parent #1/Guardian #1 Last Name *

Parent #2/Guardian #2 First Name *

Parent #2/Guardian #2 Last Name *

Home Street Address *

Unit#/Apt. #

City *

State *

Zip Code *

Main Email Address *

*

Main Contact Phone Number *

Does your child have any significant food allergies or medical conditions that we should be aware of? If so, please share those with us here. *

No, my child does not have any significant allergies or medical conditions.

Yes, my child has a significant allergy or a medical condition. Please describe in the box provided below. Yes, my child has a significant allergy or a medical condition. Please describe in the box provided below.

Tell us more about how you learned about this program: *

I have an older child who attends RBCPC Preschool

I am a church member

My child is part of HOPE Infant Program

I heard about you from a friend/relative

Other: Other:

Other Notes or Comments - please add here:

Do you plan to continue in one of our Parent Child classes in the Spring? If so we recommend you submit that additional application now. Classes fill quickly. *

Yes - my child will still be 1 year old after January - REGISTERING for Learning Together Spring Session for children 12-24 months old.

Yes - but my child will turn 2 years old by January. REGISTERING for Growing Together class for children ages 24-36 months old.

No, I will not be able to commit to the Spring Session at this time.

If you answered YES to the above question ....please click SUBMIT on this form THEN click on the appropriate link to submit the Spring Registration form