EJES After-School Pre-Registration Form

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In order to comply with COVID-19 recommended precautions and prepare for a safe After-School Program, we need information from our EJES families. Having an estimated count of program participants will help us ensure that we have adequate staffing and space available. Please answer the questions below if your family will need After-School care this year. You will need to complete a separate form for each child in your family.

Please be aware that After-School program costs will be different this year.
* A flat weekly rate of $35 per student will be required, regardless of how many days the student stays each week.
* After-School fees must be prepaid each week.

Student's First Name *

Students' Last Name *

Student's Grade *

Parent's First and Last Name *

Parent's Phone Number *

Parent's Email Address *

I understand that I must pay a one-time $15 yearly registration fee per student. *

Yes

Required

I understand that I will need to pay a flat weekly rate of $35 per student, regardless of how many days my student stays each week. I understand that After-School program fees must be prepaid each week. *

Yes

Required

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