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* Indicates required question
Email
*
Your email
Parent/Guardian Name
*
Your answer
Parent/Guardian Phone Number
*
Your answer
Student Name
*
Your answer
Student Grade
*
Choose
K4
K5
1st
2nd
3rd
4th
5th
6th
What days are you expecting to need care?
*
Monday
Tuesday
Wednesday
Thursday
Friday
Other:
Required
Expected Pick Up Time
*
Time
:
AM
PM
After Care schedule includes a snack time. How would you prefer your child to have a snack? (please check all that apply)
*
I will provide my child an additional snack for After Care
In the event my child eats his/her snack before After Care, please charge their lunch account and allow them to order from commissary.
My child may order a snack from commissary & charge it to their lunch account.
My child is NOT allowed to order from commissary for After Care Snack.
Required
Who will be picking up your child? (choose all that apply)
*
mom
dad
grandma
grandpa
babysitter
brother
sister
aunt
uncle
Other:
Required
I have read and understand the following about After Care charges:
The cost for After Care is $7.50 per hour for the first child and $4.00 per hour for each additional sibling. I will be charged a minimum of ONE HOUR regardless of how long my child attends After Care. After the first hour, I will be charged in half hour increments until my child/children is picked up.
*
Yes, I have read and agree to these terms.
Required
Send me a copy of my responses.
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