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CARES Enrollment Form 2022-2023
This enrollment form must be completed and submitted prior to using Before Care & After Care.
The annual registration fee ($25.00) and all other CARES payments will be made exclusively through Blackbaud Tuition Management.
CARES fees incurred are tallied on a weekly basis and will be included in your monthly tuition payment. Alternatively, you are welcome to make manual payments at any time through your Blackbaud account.
Be sure to complete registration fee payment using this link:
https://bngn.blackbaud.school/?id=ws4zezlxbnt#/home/
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* Indicates required question
Email
*
Your email
Family Last Name
*
Your answer
Child 1: First Name, Birthdate, & Grade
*
Your answer
Child 2: First Name, Birthdate, & Grade
Your answer
Child 3: First Name, Birthdate, & Grade
Your answer
Child/Children's Home Address
*
Your answer
Primary Family Email Address
*
Your answer
Mother's Name/Legal Guardian
*
Your answer
Mother's Home Address (if different than child's)
Your answer
Mother Home Phone (enter NA if no home phone)
*
Your answer
Mother's Cell Phone (enter NA if no cell phone)
*
Your answer
Mother's Work Phone (enter NA if no work phone)
*
Your answer
Which number is best to reach MOM during CARES hours?
*
Home
Cell
Work
Father's Name/Legal Guardian
*
Your answer
Father's Home Address (if different than child's)
Your answer
Father's Home Phone (enter NA if no home phone)
*
Your answer
Father's Cell Phone (enter NA if no cell phone)
*
Your answer
Father's Work Phone (enter NA if no work phone)
*
Your answer
Which number is best to reach DAD during CARES hours?
*
Home
Cell
Work
Describe any legal custody arrangements, if applicable. *Where a family court has designated special custody arrangements, appropriate documentation must be provided to CARES director.
Your answer
Emergency Contact #1 Name
*
Your answer
Emergency Contact #1 Phone
*
Your answer
Emergency Contact #2 Name
*
Your answer
Emergency Contact #2 Phone
*
Your answer
I/We understand that in case of an emergency, parents or legal guardians are first contacts. In the event that parents/guardians cannot be reached, two emergency contacts must be provided and will be contacted.
*
Yes
No
Other than parent/legal guardian, to whom may your child be released? *List name(s), address(es), phone(s), & relation(s) to child. *Photo ID required; include emergency contacts and others, if applicable.
*
Your answer
I/We understand that my child may only be released to parents/legal guardians and those listed above. *Photo ID required.
*
Yes
No
Required
My child has a food allergy.
*
Yes
No
My child's epipen is in school nurse's office.
Yes
No
Clear selection
My child has asthma.
*
Yes
No
My child's inhaler is in school nurse's office.
Yes
No
Clear selection
Special medical or other concerns CARES staff should know *If more than 1 child, please clearly indicate the child to whom information pertains)
Your answer
Please choose the option that best describes your intentions for the use of CARES.
*
Before Care; same days every week
Before Care; days vary week to week
After Care; same days every week
After Care; days vary week to week
Required
Please check each statement to indicate that you understand the terms of use of Holy Family's CARES program.
*
I/We Understand that by completing this form, and submitting the CARES enrollment fee payment, we will abide by the policies of the CARES program
I/We agree to pay the $25 CARES enrollment fee, and any additional charges for CARES Services as incurred.
I/We agree to notify the CARES director of any changes to the information provided in this form in a timely manner.
Other:
Required
A copy of your responses will be emailed to the address you provided.
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