Fall 2026 - Spring 2027 After-Care Registration Form

Parent First Name

Parent Last Name

Student's Name (1st child)

Student's Name (2nd Child)

1st Student's School & Grade

2nd Student's School & Grade

1st Childs Birthday

Month

Day

Year

2nd Child Birthday

Month

Day

Year

Phone

Address

Additional Information (Example) Additional Child Name, DOB,

FA26-SP27 After School Care Payments list

REGISTRATION FEE - Per Child for Fall 2026 & Spring 2027 After School Care$95

Check box to acknowledge that you understand and agree that there are NO REFUNDS.

Check this box to acknowledge that you understand and agree there is a $3.00 PER MINUTE late pick-up fee incurred for children not signed out by 6:00 PM promptly. Child Protective Services will be contacted for children left after 6:30 PM with no communication from parents regarding arrangements.

Check box to acknowledge this communication and agree that weekly payments are on AUTO-DRAFT and include a $5.00 service fee.