2021-2022 LATCHKEY ENROLLMENT
You will receive an email once your enrollment is processed. This email will have drop off/pick up information and tuition information.

Once this form is submitted,  you will be billed a $20 non-refundable Enrollment Fee per child. This plus first month's tuition will be due prior to being able to start Latchkey Service.

Filling out this form DOES NOT mean your child will be able to attend Latchkey immediately. You will receive a Notice of Acceptance email when you are processed and ready to start.

YOU MUST RECEIVE A CONFIRMATION EMAIL BEFORE YOU CAN BEGIN. WE REQUIRE NO LESS THAN 2 BUSINESS DAYS PRIOR TO STARTING FOR ENROLLMENTS.
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Student Information
Child #1 Building: *
Child # 1 First Name *
Child # 1 Last Name *
Child # 1 Gender *
Child # 1 Birth Date *
MM
/
DD
/
YYYY
Child # 1 Grade *
Start Date *
MM
/
DD
/
YYYY
Child # 1 Teacher (if unknown please leave blank)
Does Child #1 have an IEP? *
Does Child #1 Have a 504? *
Any other special needs or considerations we need to be aware of? *
Child #2 Building:
Child #2 First Name
Child #2 Last Name
Child #2 Gender
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Child #2 Birth Date
MM
/
DD
/
YYYY
Child #2 Grade
Start Date
MM
/
DD
/
YYYY
Child #2 Teacher  (if unknown please leave blank)
Does Child #2 have an IEP?
Clear selection
Does Child #2 have a 504?
Clear selection
Any other special needs or considerations we need to be aware of?
Parent Information
Parent #1 Relationship to Child (Responsible Party) *
Parent #1 Name (Responsible Party) *
Parent #1 Address *
Parent #1 Home Phone
Parent #1 Cell Phone *
Parent #1 Work Phone
Parent #1 Employer
Parent #1 E-mail Address
Parent #2 Relationship to Child
Parent #2 Name
Parent #2 Address - If same as parent one - Please type "SAA"
Parent #2 Home Phone
Parent #2 Cell Phone
Parent # Work Number
Parent #2 Employer
Parent #2 E-Mail Address
Custodial Information
The Above Child(ren) live with: *
Is there a shared custody agreement? *
Emergency Contacts AND Persons to Pick Up Child
Please provide at least two people other than parents/guardians to contact in an emergency or who may pick the child(ren) up from the program. Prioritize the contacts. We will call them in the order listed.
Emergency Contact #1 Name *
Emergency Contact #1 Relation to Child *
Emergency Contact #1 Contact Number *
Emergency Contact #2 Name *
Emergency Contact #2 Relation to Child *
Emergency Contact #2 Contact Number *
Emergency Contact #3 Name
Emergency Contact #3 Relation to Child
Emergency Contact #3 Contact Number
Schedule
Commitment of Days:   Monthly Billing and Scheduling (Latchkey Tuition due on the First of each month)
I am committing my child to the following days/sessions and will be charged each month accordingly.
Please select  the appropriate schedule below: *
For specific Days - Please fill out.
AM
PM
Both
None
Monday
Tuesday
Wednesday
Thursday
Friday
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Important Policy Information
*I understand I will be charged on a monthly basis for the schedule I have indicated above.   **Please type initials below** *
Any changes to your schedule must accompany a Change of Schedule (a two-week notice).  **Please type initials below**   *
Confirmation of Information
Statements entered in SIS can be viewed via Parent Portal.  End of the year Tax Statements will be mailed.

Signatures (By checking the box- I agree to adhere to the Procedures, Policies and Rules stated in the Policy Handbook)
Your signature on this form indicates that you are in agreement with the Authorized Emergency Contacts, Billing Information and Commitment of Days. Please see the Latchkey Policy Handbook for additional information.

By checking the box- I agree to adhere to the Procedures, Policies and Rules stated in the Policy Handbook. Your signature on this form indicates that you are in agreement with the Authorized Emergency Contacts, Billing Information and Commitment of Days. Please see the Latchkey Policy Handbook for additional information. You can view the policy handbook here: https://www.troy.k12.mo.us/Page/Latchkey  *
Signatures
By typing your name you are agreeing to adhere to the Procedures, Policies an Rules stated in the Policy Handbook.
Please type your name and date below. By doing so you are indicating that you are in agreement with the Authorized Emergency Contacts, Billing Information, Commitment of Days and that you have read and understand the Policy Book. *
THANK YOU
Thank you for submitting your enrollment for the Latchkey Program. Once the enrollment has been processed you will receive an email containing amount due and pick and drop procedures for your student's building.
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