SJS Before/Aftercare Registration

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Complete this form to enroll your student(s) in our Before/Aftercare Program.

Please note that by enrolling your student(s), you will be charged a $40 registration fee through FACTS for your family to cover the cost of program supplies.

Student Name(s) *

Parent/Guardian Contact Information - Please include NAME(S) and PHONE NUMBER(S) of primary parent(s)/guardian(s). *

How many BEFORE CARE days are you committing your student(s) to attend?

Before Care - 1 day per week commitment

Before Care - 2 days per week commitment

Before Care - 3 days per week commitment

Before Care - 4 days per week commitment

Before Care - 5 days per week commitment

How many AFTERCARE days are you committing your student(s) to attend?

Aftercare - 1 day per week commitment

Aftercare - 2 days per week commitment

Aftercare - 3 days per week commitment

Aftercare - 4 days per week commitment

Aftercare - 5 days per week commitment

Which weekdays will you need before or aftercare?

Before Care

Aftercare

Monday

Tuesday

Wednesday

Thursday

Friday

Schedule Varies

In the event of an emergency, the parents/guardians will be contacted first. List 2 other Adult Names and Phone Numbers to be contacted if the parents/guardians cannot be reached. These adults must be on the student's authorized list for pick up in the SJS Office. *

SAFETY: Student and staff safety is very important. In addition to the rules enforced during the school day, the basic rules of our Before/Aftercare Program are to be kind, be respectful, and to be productive. In the instance of a student not following these basic rules, the SJS Before/Aftercare Program Leader will follow SJS School Guidelines. *

By checking this box, you are committing to ensure your student(s) understands and will follow our program rules.

Required

HOURS: Students may not be dropped off before the start of the Before Care Program (7:00am) and MUST be picked up at the end of the Aftercare Program (5:30pm). Only adults authorized by the student’s parent/guardian (which will be on file with the SJS Office) may pick up students. The Program Leader will follow SJS protocols if a student is not picked up by 5:30pm. *

By checking this box, you understand and will follow our program rules.

Required

PAYMENTS: I understand that I will have to pay the registration fee, program commitment, and/or punch passes through FACTS. Monthly commitments are non-refundable, but can be changed on a month-to-month basis. Before Care - $7 fee, After Care- $7 fee. Registration Fees and Punch Passes are non-refundable. *

Yes, I understand.

Required

This section is for additional questions or comments.

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