2025-26 Before/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,

Fall 2026 - Before / After School Care Payments list

REGISTRATION ONLY Fall 2026 School Care$95

2026 After-School Care ONLY (2:30pm-6:30pm) weekly. ($115 + $5 service fee)$120

2nd child After -School Care ONLY (2:30pm-6:30pm) weekly. ($103 +$5 service fee)$108

2026 Before-School Care ONLY (6:30am-7:30am) weekly. ($115 + $5 service fee)$120

2nd Child Before-School Care ONLY (6:30am-7:30am) weekly.($103 + $5 service fee)$108

BOTH Before & After Care (6:30am-7:30am) & (2:30pm-6:30pm)$130

2nd child BOTH Before & After Care (6:30am-7:30am) & (2:30pm-6:30pm)$117

Check box to acknowledge this communication that future weekly payments are on auto-pay and include a $3.00 convenience fee.

Product

Product 1$0