Please take the time to properly fill out the below form. Our system will immediately tell you if there are slots available for the appropriate age group and the number of days per week you desire. If we have an opening, your slot will be reserved for one week. During that week you will need to contact the center and complete the remaining paperwork. If no slots are currently available, you will be placed on a waiting list. You will be contacted by a Riverwood employee with an estimate of how long the wait will be. We thank you for your support and look forward to helping your children grow and learn.

Child's Info
First Name :
Middle Initial :
Last Name :
Nickname :
Birthdate : (Format: MM/DD/YY)
Phone :
Address :
City :
State :
Zip :

Father's Info (leave blank if info is same as child's)
Name :
Phone :
Address :
City :
State :
Zip :
Email :
Cell :
Place of Employment :
Business Phone :

Mother's Info (leave blank if info is same as child's)
Name :
Phone :
Address :
City :
State :
Zip :
Email :
Cell :
Place of Employment :
Business Phone :

Age Group and Days
Age Group :
Days :
Part Time :




204 Cunningham Lane, Clayton NC 27520
Phone: (919) 550-9200 FAX: (919) 550-0571
NC ID# 5100465
info@riverwoodchild.com
Hours: Monday thru Friday 6:30 AM - 6:00 PM