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Extended Care May/June 2022 - DUE 4/21/22
Please complete this form to enroll in Extended Care for the month of April 2022.
Form is due to be submitted no later than Sunday March 27. Payment is due same day as registration.
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Email
*
Your email
FOR MULTIPLE STUDENTS IN ONE FAMILY
If SAME schedule = Submit 1 form for all children
If DIFFERENT schedules = Submit 1 form for EACH child
Student First Name(s)
*
Your answer
Students Last Name(s)
*
Your answer
WEEK 1 of 6 May 2-6
*
AM Only
PM Only
BOTH AM and PM
No care needed
BOTH AM and P
Column 7
Column 6
Monday 5/2
Tuesday 5/3
Wednesday 5/4
Thursday 5/5
Friday 5/6
AM Only
PM Only
BOTH AM and PM
No care needed
BOTH AM and P
Column 7
Column 6
Monday 5/2
Tuesday 5/3
Wednesday 5/4
Thursday 5/5
Friday 5/6
WEEK 2 of 6 May 9-13
*
AM Only
PM Only
BOTH AM and PM
No care needed
Monday 5/9
Tuesday 5/10
Wednesday 5/11
Thursday 5/12
Friday 5/13
AM Only
PM Only
BOTH AM and PM
No care needed
Monday 5/9
Tuesday 5/10
Wednesday 5/11
Thursday 5/12
Friday 5/13
WEEK 3 of 6 May 16-20
*
AM Only
PM Only
BOTH AM and PM
No care needed
Monday 5/16
Tuesday 5/17
Wednesday 5/18
Thursday 5/19
Friday 5/20
AM Only
PM Only
BOTH AM and PM
No care needed
Monday 5/16
Tuesday 5/17
Wednesday 5/18
Thursday 5/19
Friday 5/20
WEEK 4 of 6 May 23-27
*
AM Only
PM Only
BOTH AM and PM
No care needed
Monday 5/23
Tuesday 5/24
Wednesday 5/25
Thursday 5/26
Friday 5/27
AM Only
PM Only
BOTH AM and PM
No care needed
Monday 5/23
Tuesday 5/24
Wednesday 5/25
Thursday 5/26
Friday 5/27
WEEK 5 of 6 May 30-June 3 (No School on Memorial Day)
*
AM Only
PM Only
BOTH AM and PM
No care needed
Tuesday 5/31
Wednesday 6/1
Thursday 6/2
Friday 6/3
AM Only
PM Only
BOTH AM and PM
No care needed
Tuesday 5/31
Wednesday 6/1
Thursday 6/2
Friday 6/3
WEEK 6 of 6 June 6-8 (Last Week of School)
*
AM Only
PM Only
BOTH AM and PM
No care needed
Monday 6/6
Tuesday 6/7
Wednesday 6/8
AM Only
PM Only
BOTH AM and PM
No care needed
Monday 6/6
Tuesday 6/7
Wednesday 6/8
REGISTRATION PER CHILD
Please note how many days you are enrolling EACH student this month
How many PM ONLY Days?
*
Choose
NO PM $0
1 PM $15
2 PM $30
3 PM $45
4 PM $60
5 PM $75
6 PM $90
7 PM $105
8 PM $120
9 PM $135
10 PM $150
11 PM $165
12 PM $180
13 PM $195
14 PM $210
15 PM $225
16 PM $240
17 PM $255
18 PM $270
19 PM $285
20 PM $300
21 PM $315
22 PM $330
23 PM $345
24 PM $360
25 PM $375
26 PM $390
27 PM $405
28 PM $420
29 PM $435
30 PM $450
How many AM ONLY Days?
*
Choose
NO AM $0
1 AM $12
2 AM $24
3 AM $36
4 AM $48
5 AM $60
6 AM $72
7 AM $84
8 AM $96
9 AM $108
10 AM $120
11 AM $132
12 AM $144
13 AM $156
14 AM $168
15 AM $180
16 AM $192
17 AM $204
18 AM $216
19 AM $228
20 AM $240
21 AM $252
22 AM $264
23 AM $276
24 AM $288
25 AM $300
26 AM $312
27 AM $324
28 AM $336
29 AM $348
30 AM $360
How many AM and PM Days?
*
Choose
NO AM/PM $0
1 AM/PM $27
2 AM/PM $54
3 AM/PM $81
4 AM/PM $108
5 AM/PM $135
6 AM/PM $162
7 AM/PM $189
8 AM/PM $216
9 AM/PM $243
10 AM/PM $270
11 AM/PM $297
12 AM/PM $324
13 AM/PM $351
14 AM/PM $378
15 AM/PM $405
16 AM/PM $432
17 AM/PM $459
18 AM/PM $486
19 AM/PM $513
20 AM/PM $540
21 AM/PM $567
22 AM/PM $594
23 AM/PM $644
24 AM/PM $648
25 AM/PM $675
26 AM/PM $702
27 AM/PM $729
28 AM/PM $756
29 AM/PM $783
30 AM/PM $810
PAYMENT DETAILS
Amount Due per child:
*
Your answer
Total Amount Paid (for ALL children):
*
Your answer
Payment made via:
*
Online
Check
Cash
Payment Date
*
MM
/
DD
/
YYYY
Thank you for your continued support and trust in Three Rivers Montessori to care for your children.
A copy of your responses will be emailed to the address you provided.
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