2023 - 2024 Cub House Form

We are excited for the 2023-2024 school year! Please complete the Cub House Form below to request a possible slot for your child for the 21CCLC After School Cub House Program. If you have multiple students, please complete a separate form for each child.  

Cub House has limited enrollment availability. Slots will be allocated on a first-come, first-served basis using the timestamped form submissions. We understand the high demand for Cub House, and as such, each student will be placed on a waiting list. A phone call or email will be sent to all enrolled students. This form serves as an expression of interest and is not an enrollment form. 

To facilitate smooth end-of-day transitions, we request that students enrolled in Cub House be picked up no earlier than 3:45 pm on weekdays and 2:45 pm on Fridays. No

Family Information for the 2023 - 2024 School Year:

  • Hours for Cub House will be after school until 5:30 at each campus.
  • Bus transportation will not be provided after Cub House. All students will be car riders.
  • PreK and Kindergarten students will be at MECC
  • 1st grade - 3rd grade students will be at MES
  • 4th grade - 8th grade students will be at MIS/MMS (more information will be shared about the MMS site upon enrollment)
  • All students in PreK - 8th grade will be provided, at a minimum, an afterschool snack.  

Thank you! We are excited for another great year serving students in the afterschool program.

Sign in to Google to save your progress. Learn more
Student Last Name *
Student First Name *
Please select the grade your child will be going into for the 22-23 school year. 
(PreK students must be 4 years old) *
Please list all siblings that could possibly attend Cub House for the 22 - 23 school year.
If none - please write "none"
 *
Special medical needs or allergies:
If none - please write "none"
 *
Parent/Guardian Name:
 *
Email address:
 *
Telephone Number:
(Please add a primary contact and a different secondary contact) *
This section is for 4th grade - 8th grade students only:
Please select your child's home route.
 *
Select Days Attending:
(select "Everyday" or choose days attending below)
 *
Required
5:30 pick up time will be strongly enforced so that Cub House staff are able to get home to their families.  To help with this the following policy will be used:
1.  Verbal warning
2.  A written notice of the pick up time with parent signature.
3.  Suspension from the program for one week.
4.  Expelled from the program and student slot given to another student. 
 *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Monett R-1 School District. Report Abuse
Google Forms