2024-2025 Before Care/Aftercare Registration Form
2024-2025 Before Care/Aftercare Registration
Before School Hours (K - 8th Grade): Monday - Friday from 7:00 - 7:45am
After School Hours (Pre-K - 8th Grade): Mondays, Tuesdays, Wednesdays, and Fridays from 3:00 - 5:30pm; Thursdays from 2:30 - 5:30pm
Cost: Before School Enrichment Program = $5.00 per day
Cost: After School Enrichment Program = $45.00 per student per week $12.00 /day for after school enrichment if you are part-time/ on certain days. (Financial Aid is available) 

Payments can be made online through MySchoolBucks bi-weekly.   
Deadline to Register is: Monday, July, 15 2024
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Date of Submission *
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Grade *
Before Care and/or Aftercare Needed? *
Days Needing Care *
Required
Child's Name *
Child's Date of Birth *
MM
/
DD
/
YYYY
Primary Parent/Guardian Name *
Primary Parent/Guardian Email Address *
Primary Parent/Guardian Cell Phone Number *
Primary Parent/Guardian Other Phone *
Primary Parent/Guardian Address  *
Secondary Parent/Guardian Name *
Secondary Parent/Guardian Cell Phone  *
Secondary Parent/Guardian Other Phone Number *
Secondary Parent/Guardian Address  *
Emergency Contact Name and Phone Number 1 *
Emergency Contact Name and Phone Number 2 *
Emergency Contact Name and Phone Number 3 *
Medical Contact Physician Name and Phone Number *
Dentist Name and Phone Number *
Other *
Sign to grant permission to provide first aid and transportation to emergency care facilities if ever necessary. *
Child's Medical/Health Needs *
Child's Allergies/Treatment *
Child's Dietary Needs/Restrictions *
Other Needs *
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