Extended Day Registration 2023-2024
The following form just be filled out prior to your child participating in the Extended Day Program at Mayfair Lab School.  Please read the Extended Day Program Handbook before filling out the form.  If you have any questions please contact Shari Tullier at 225-761-7849 or email Sluker@ebrschools.org.
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Student Name *
Grade *
Which plan will your child be enrolling in: *
Email address for invoices: *
Parent #1 First and last name: *
Parent #1 cell phone number: *
Parent #1 work phone number: *
Parent #2 First and last name *
Parent #2 cell phone number: *
Parent #2 work phone number: *
First emergency contact name: *
Emergency contact phone number: *
Second emergency contact name: *
Emergency contact phone number: *
List any people allowed to pick up student besides parents and emergency contacts: *
My signature on this agreement indicates that I have read the Extended Day Program Handbook and agree to abide by the rules and regulations of the Mayfair Lab Extended Day Program.   *
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