2024-2025 Rebel Kids Care Summer and School Year Request Form
Rebel Kids Care Childcare is for district enrolled students K-5th grade.   RKC is based out of the DGF Elementary site. Parents can begin filling out the 2024-2025 school year request form starting 3/1/24. All families will need to complete the RKC Request Form. RKC staff will review requests and let families know if we have space for your child/ren or if they are added to the waitlist.  Please complete one Request Form per child.  

Registration is NOT confirmed until you receive confirmation from the Community Education Office.   Once you receive confirmation that we have room for your student/s, we will send you confirmation or enrollment forms and then you can submit your registration or supply fee. 

Priority is given to full-time enrollment of 5 days per week.  Full time enrollment is considered 5 days per week of before school and after school during the school year or 5 days per week during the summer. Children may attend less but you parents/guardians will be invoiced for a full time spot.

If you have any questions, please contact Tracy Tollefson at 218-477-6805.

Sign in to Google to save your progress. Learn more
Email *
Student First and Last Name *
Student Grade (Grade they will be in for the 2024-2025 school year) *
Student Birthdate *
MM
/
DD
/
YYYY
Classroom Teacher - Students will not know their teacher for next year yet so leave this field blank if you are unsure.
Allergies (If no allergies, please write "None") *
Each child brings their own uniqueness to the program.  If your child receives services through Special Education, or has a behavior plan developed, please contact Tracy Tollefson at 218-477-6805 or rebelkidscare@dgf.k12.mn.us.  A meeting will need to be set up with you to do an individualized assessment regarding your request to have your child participate in Rebel Kids Care.  This meeting will determine if Rebel Kids Care is an appropriate and safe setting for your child to succeed independently.  The child’s start date may be delayed depending on the number or staff available with the skill-set necessary to meet your child’s needs. *
Required
Address *
City *
State *
Parent First and Last Name (1) *
Parent Email (1) *
Parent Cell Phone (1) *
Parent First and Last Name (2)
Parent Email (2)
Parent Cell Phone (2)
Summer 2024:  Please note what care you are requesting.   *
Required
If your child is requesting to enroll part time (less than five days per week), are there specific days of the week that you know they are attending or will it change weekly?
Clear selection
If requesting part-time enrollment, what days would work best for your child to attend?
Clear selection
School Year 2024-2025:  Please note what care you are requesting.  Priority is given to full time enrollment. Parents who choose full time can attend less days but must pay for the full-time spot to prioritize their child's enrollment. Once we review your request form, we will notify you if we have room or if your child needs to be added to the waitlist. *
Required
If you have any questions or comments, feel free to note here and we will respond.  If none, leave blank.
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Dilworth Glyndon Felton School District 2164. Report Abuse