Enroll with RMK!

Enrollment Application:
1) Please complete the following webform to enroll each of your children individually with RMK.

2) Once you submit this form, submit your credit card information using this secure web form.

You should receive confirmation within 48¬†hours of submission. Your child may not attend care until your enrollment is fully complete. Email us with any questions at [email protected]¬†.

If you are already enrolled, and need to update your card on file only, please click here
Child First Name
Email address (Primary)
Phone Number (Primary)
Is your child up to date on state required immunizations (Type Yes or No)
Child Last Name
Parent/Guardian #1 Name (First Last)
Parent/Guardian #2 Name (First Last) [optional]
Phone Number (Secondary) [optional]
Email address (Secondary) [optional]
Child Birth Date
School & Current Grade (Ex: Frontier, 5th)
Persons authorized to pick up child (other than parents) [optional]
Doctor Name (First Last)
Doctor Phone Number
Clinic/Hospital of Choice (Name, Address) [optional]
Please list any allergies (If none, type none or N/A)
Please list any medications (If none, type none or N/A)
Any other conditions you would like our staff to be aware of: [optional]
Health Insurance Company:
Health Insurance Policy Number:
In case of emergency, I authorize the staff or physician to take action in best interest of my child's health. (Initial below)
I agree to abide by all policies and procedures stated in the Parent Handbook. (Initial below)
I consent that Rocky Mountain Kids is not liable for my child before check-in & after check-out with RMK. (Initial below)
I agree to keep my child's records up to date to the best of my ability. (Initial below)
Please list approved visual programming below: [None, TV programs, G-Rated Movies, and/or PG-Rated Movies]
I agree to allow RMK to occasionally photograph or video my child during program activities. (Initial below or "NO")
I agree to allow my child to be transported in an approved vehicle when necessary with RMK (Ex: Fieldtrip). (Initial below or "NO")
I give consent for Rocky Mountain Kids to apply sunscreen to my child as needed to avoid UV harm. (Initial below or "NO")
Full name of person giving consent on this form:
Please list any specific activities you wish for your child to be excluded from: [optional]
Are you a US Military Servicemember, or Veteran? (Yes or No) [Email photo of Military ID to receive discount]
Security question to be used in case of emergency
Answer to security question:
I authorize my credit card to be charged in accordance with my package selection & required fees. (Initial below)
Are you a staff or faculty member of an RMK partner school (Yes or No) [Email a copy of your school ID to receive discount]
Are you an approved CCCAP recipient? (Yes or No)
Are you an approved free/reduced lunch program participant? (Yes or No)
Doctor Address
Dentist Name
Dentist Address
Dentist Phone Number
I understand before my enrollment can be complete I must submit credit card information via a separate online form as well as necessary medical forms (Initial below)
Submit
Downloadable Enrollment Form (Hard Copy Option)