SSC Latchkey Registration 2022-2023
Latchkey is the after-school care program provided by Shenandoah School Corporation. Please fill out the following information to register your child(ren). If you have any questions please contact Jake Wiese at: jwiese@shenandoah.k12.in.us 
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Email *
Child's First and Last Name *
Parent E-mail address *
Child's Teacher and Grade *
When will your child need to attend? *
Mothers First and Last Name *
Mothers Cell/Primary Phone Number *
Mothers Employer and Work Number *
Father's First and Last Name *
Father's Cell/Primary Phone Number *
Father's Employer and Work Number *
With Whom is the Child Living? *
Emergency Contact and Phone Number *
List the people who are authorized to pick up your child. *
In the event of an emergency closure, and/or early dismissal, what is the dismissal plan for your child?  Please indicate if your child will ride the bus (including bus number) or if your child will be a car rider, and whom may pick them up. *

The Latchkey program ends at 6:00pm. There is a late fee of $25 applied at 6:01 pm. The late fee will be applied to your account every 10 minutes until the child is picked up. Example: 6:11pm-charged $25/6:21pm-charged $25...etc. By selecting YES you agree to the late fee policy and understand that your child will not be allowed to return until late fees have been paid. *
Signature of Parent or Guardian *

Please indicate if your child has any special medical need or specific assistance needed. If so, a follow up information card will be needed to ensure the proper care for your child.
 *

Do you understand that you are responsible for letting the Latchkey Director and the school know what days your child will be attending every week?
 *
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