1 Step 1
RBCC Student Enrollment Application
Program Type
Gender

**NOTE: If any of the information above changes, please notify the RBCC office immediately.

​

EMERGENCY CONTACT INFORMATION

​List 2 (Two) emergency contacts other than those listed above

EMERGENCY MEDICAL RELEASE


If any emergency medical care is necessary and I cannot be reached, I authorize the Rainbow Bridge Culture Center to act on my behalf in granting permission for my child to receive emergency medical treatment. I acknowledge that I will be responsible for all expenses incurred as the result of medical treatment.

Parent/Legal Guardian Signature
(Sign Here)
Clear Signature
Photography Policy


I, (parent/guardian)

for these following purposes:

, give permission to RBCC to photograph & video record my (child)

Scrapbooking use
Showcasing RBCC to current and potential clients
Displayed on RBCC’s bulletin board
Displayed on RBCC’s Website
RBCC’s Community WeChat Group
Release of Liability

In consideration of allowing the previously declared participant(s) to begin participation in Rainbow Bridge Culture Center Classes, while on the premises and property of said felicity, the undersigned, for themselves, and/or being the legal and acting guardian of participant(s), acting for themselves and on behalf of the participant(s), release and hold harmless Rainbow Bridge Culture Center Classes, its owners, employees, and agents of and from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant and/or the undersigned, while in or upon the premises upon which Rainbow Bridge Culture Center Classes is conducted, or any premises under the control and supervision of Rainbow Bridge Culture Center Classes, its owners, officers, employees, or agents or in route to or from any of the said premises, or while at any premises or place when activities sponsored by or participated in by Rainbow Bridge Culture Center Classes, its owners, officers, agents,
or employees.​

Parent/Legal Guardian Signature
(Sign Here)
Clear Signature
ClASSES GUIDELINES & POLICIES

* Classes start on time, please allow kids to be on time.
* Please inform the teacher via RBCC Wechat group or private message to teacher if child will be missing a class. Children have 30 days to make up missed classes.​

* Parents/ Guardians must wait in the waiting area while classes are in session. This is to stop any disruption or concentration in the class.

* Please remember that classes is not meant to be a babysitting service. Children are expected to interact with other children and are required to participate in all activities as instructed by the RBCC staff.
* Failure to follow these guidelines and policies can result in your child being expelled from this program.
* Disrespect to the RBCC staff, refusal to follow instruction, fighting, and/or bullying of any kind, will lead to immediate dismissal of this program.

I have read and understood Rainbow Bridge Culture Center Classes Guidelines and Policies

Parent/Legal Guardian Signature
(Sign Here)
Clear Signature
Tuition Rates (Monthly)

PLEASE SELECT CAREFULLY

Art Classes:
Chinese Class
Chess Class

Please Note: Monthly Tuition is due at the 7th(seventh) of each month.

Parent/Legal Guardian Signature
(Sign Here)
Clear Signature

**This form is will be applied to all Camps (Day, Break, Summer) that are held at Rainbow Bridge Cultural Center in the year 2021**
All camps will be held from 8:30 A.M to 6:00 P.M
PLEASE PRINT AND COMPLETE THE FOLLOWING INFORMATION

Child Info
NameAgeDate of BirthGender(M/F)Allergies/Medical Concerns
×
(1)

Emergency Contact

Additional Emergency Contact
NamePhone #AddressAuthorized to pick up child: Yes / No
×
(1)

Camp(s) Guideline and policies

Registration: In order to attend one or more Rainbow Bridge Culture Center (RBCC) camp(s), this form must be completed and handed over to the office at RBCC.

Tuition: Tuition must be paid with cash or check. A $25 (Twenty-Five Dollar) fee will be added on account for cancelled checks.

Sibling Discount: For families with 2(Two) children that attend camp, only the second child will receive a discount of 10 (Ten) percent off their camp tuition. For families with 3(Three) or more children that attend camp, a discount of 10(Ten) percent will be applied to the total camp tuition.

Lost/Broken/Stolen Items: RBCC will not be held responsible for any items that are brought into RBCC that get lost, broken, or stolen. Please do not bring items that may run the risk of getting lost, stolen, or broken.

Pickup Time: Parents MUST pick up their child by 6:00 pm, or a late fee of $5(Five Dollars) for each 15 minutes past 6:00 pm, will be put on account.

Lunch: Lunch will not be provided. Please bring a bagged lunch for your child(ren). There is a microwave on site if parents want to bring a hot lunch for their child(ren).
Participation: Please remember that this program is not meant to be a babysitting service. Children are expected to interact with other children and are required to participate in all activities as instructed by the RBCC staff.
SUMMER CAMP ONLY: At the time of registration: there will be a $50 (Fifty Dollar) registration deposit. At the end of the summer camp season, the deposit will be refunded back to the parent/ guardian. However, if 1(one) of the 2 (two) conditions are met, then the refund won’t be refunded.

I have read and understood Rainbow Bridge Culture Center Camp(s)Program Guidelines and Policies.

Parent/Legal Guardian Signature
(Sign Here)
Clear Signature

PHOTOGRAPH POLICY

following purposes:

Scrapbooking use
Showcasing RBCC to current and potential clients
Displayed on RBCC’s bulletin board
Displayed on RBCC’s Website
RBCC’s Community WeChat Group

PROGRAM WAVIER

I have registered for enrollment of my child(ren) to attend Rainbow Bridge Cultural Center (RBCC) camp(s). I have made RBCC aware of any health concerns, behavioral issues, and other important issues that pertain to my child’s education. I release all owners, administrators, instructors, or participants of any actions, or suits which could result from accidents or injuries while my child(ren) are enrolled for RBCC camp(s). I understand that RBCC reserves the right to cancel this contract at any time with a prorated refund.

Parent/Legal Guardian Signature
(Sign Here)
Clear Signature
How did you hear about RBCC camp(s)?

​Emergency Medical Release

If any emergency medical care is necessary and I cannot be reached, I authorize the Rainbow Bridge Culture Center to act on my behalf in granting permission for my child/children to receive emergency medical treatment. I acknowledge that I will be responsible for all expenses incurred as a result of medical treatment.

Parent/Legal Guardian Signature
(Sign Here)
Clear Signature

​Emergency Release

Consent to emergency first aid and transportation:

, may be given emergency treatment by a Rainbow Bridge Culture Center staff member. I also give permission for my child to be transported by car or ambulance to an emergency center for treatment and agree to hold Rainbow Bridge Culture Center and its employees harmless in the event of any accident. I understand that Rainbow Bridge Culture Center will provide proper supervision and will follow the state licensing regulation to take precautions to avoid accidents.

Parent/Legal Guardian Signature
(Sign Here)
Clear Signature

Illness Policy

We strive to keep our children safe and healthy in the center. We encourage parents to cooperate with us to create a healthy environment. Each day when a child arrives, Rainbow Bridge Culture Center staff members will evaluate the child for any signs or symptoms of illness. COVID-19 symptoms will also be part of our evaluation. We ask that parents should not cover symptoms of your child/children. We also require parents NOT to bring a child to the center when ill. It is not acceptable to simply give your child Tylenol/ibuprofen to cover the fever and bring him/her to the center. We are pleased to dispense medications to children prescribed by their doctors. Please provide the listed information when ask for dispensing medication to children:

  • ​The original bottle of medication (with children’s full name)
  • Doctor’s prescription
  • Detailed instructions for administering the medication
  • Possible side effects
Parent/Legal Guardian Signature
(Sign Here)
Clear Signature

Sunscreen and Insect Repellent Consent

I consent that Rainbow Bridge Culture Center use sunscreen on my child/children when he/she plays outside. I understand by denying this policy, my child/children will not be allowed to play outside without any preparation and protection. Parents are asked to provide sunscreen they would like to use.
Sunscreen must be SPF 30 or higher.
Insect repellent is recommended when insects such as mosquitos may be present outside. Parents are asked to provide the insect repellent they would like to use on their children.

Parent/Legal Guardian Signature
(Sign Here)
Clear Signature
Please Indicate Which Weeks and Days You Would Like to Register for RBCC Summer Camp
Week # 1-10How Many Day(s) 1-5Date(s)
×
(1)
Daycare type
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