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2024 JCKC Summer Aftercare Program Registration Form
2024 JCKC Summer School Aftercare Information
2024년 쟌스크릭 한인교회 여름학교 방과후 돌봄 프로그램 안내
CONTACT 문의:
JCKC Community Center 770-298-7834 /
jckcsummerschool@gmail.com
DATE: 6/3 - 7/19 (독립기념일 주간 휴강 / No Program for July 1st - Jul 5th)
TIME:
Preschool Extended Program :
Age 3 & Pre-K ; 1:30 pm - 3 pm ; 한 주 45불 ($45/week)
Aftercare Program : K - 8th ; 3 pm - 6 pm ; 하루 20불 ($20/day)
Early Drop Off : From 8 am ($7)
* LATE PICK-UP FEE:
픽업 시간을 준수하지 못할 경우, 1분당 $1씩 Late Fee 가 적용될 수 있습니다.
Late Pick-up Fees may apply if you fail to comply with the pickup time ($1/ min).
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* Indicates required question
Email
*
Your email
학생 성 Last Name
*
Your answer
학생 이름 First Name
*
Your answer
학생 한글 이름 Child's Korean Name (if applicable)
*
Your answer
등록 학생 생일 Date of Birth
*
MM
/
DD
/
YYYY
등록 학년 Grade (2023-2024 School Year)
*
3-year-old
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
Required
등록 학생 성별 Gender
*
남자 Male
여자 Female
(유치원생) 방과후 돌봄 신청 주간 Preschool Extended Program Application Week (For 3 yrs & Pre-K ; 1:30 pm-3 pm; $45/week)
*
• Week 1 ( Week of Jun 3rd )
• Week 2 ( Week of Jun10th )
• Week 3 ( Week of Jun 17th )
• Week 4 ( Week of Jun 24th )
• Week 5 ( Week of July 8th )
• Week 6 ( Week of July 15th )
None
Required
(유치원생) 방과후 돌봄 신청 요일 Preschool Extended Program Application Days (Only for 3 yrs & Pre-K)
*
Monday
Tuesday
Wednesday
Thursday
Friday
None
Required
(초등/중학생) 방과후 돌봄 신청 주간 Elementary & Middle Schoolers' Aftercare Application Week (Only for K - 8th Grade; 3 pm-6 pm; $20/day)
*
• Week 1 ( Week of Jun 3rd )
• Week 2 ( Week of Jun 10th )
• Week 3 ( Week of Jun 17th )
• Week 4 ( Week of Jun 24th )
• Week 5 ( Week of July 8th )
• Week 6 ( Week of July 15th )
None
Required
(초등/중학생) 방과후 돌봄 신청 요일 Elementary & Middle Schoolers' Aftercare Application Days (Only for K-8th Grade)
*
Monday
Tuesday
Wednesday
Thursday
Friday
None
Required
빠른 등교 신청 주간 Early Drop-off Week(s) ($7/hour)
*
• Week 1 ( Week of Jun 3rd )
• Week 2 ( Week of Jun10th )
• Week 3 ( Week of Jun 17th )
• Week 4 ( Week of Jun 24th )
• Week 5 ( Week of July 8th )
• Week 6 ( Week of July 15th )
None
Required
빠른 등교 신청 요일 Early Drop-Off Day(s) (From 8 am)
*
Monday
Tuesday
Wednesday
Thursday
Friday
None
Required
특별 당부 사항 (건강, 알러지, 염려등) Special Instructions (Health, Allergy, Concerns)
*
Type N/A if not applicable
Your answer
어머니/보호자 이름 Mother/Guardian Name
*
Your answer
어머니/보호자 전화번호 Mother/Guardian Phone Number
*
Your answer
아버지/보호자 이름 Father/Guardian Name
*
Your answer
아버지/보호자 전화번호 Father/Guardian Phone Number
*
Your answer
비상 연락 대상 Emergency Contact Person
*
부모님 외에 비상시 연락할 수 있는 사람
Your answer
비상 연락 전화번호 Emergency Contact's Phone Number
*
Your answer
주소 Mailing Address
*
Your answer
책임 면제를 위한 동의서 Consent Form for Liability Waiver
*
I allow my child to participate in After Care Program. During any part of the program, I hereby agree not to hold the church legally and/or financially liable in the event of an unforeseen accident. 저는 저의 아이(들) 가/이 방과후 돌봄 프로그램에 참여하는 것을 허락합니다. 그리고 프로그램의 어떠한 부분에서든지 예기치 않은 사고에 대해서 법적으로나 재정적으로 교회에 책임이 없다는 사실에 동의합니다.
네, 동의합니다 / Yes, I agree.
아니오, 동의하지 않습니다 / No, I disagree.
서명 Please Type your Name as Applicant Signature
*
상기 모든 사항을 읽고 이해했음을 확인합니다 I certify that I have read and understand all of this.
Your answer
A copy of your responses will be emailed to the address you provided.
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