KJ Afterschool Registration - Greensboro Academy

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KJ Afterschool Registration - Greensboro Academy - 2022-23

The program is currently full but may have openings pop up as the school year begins. Please fill out the information below but DO NOT PAY A REGISTRATION FEE at this time. When a spot opens, we will contact families in order of their wait list position.

Email *

Is your child's school Greensboro Academy? If yes, please continue. If not, please go back to our homepage and click on the form associated with your child's school. *

Yes, my child's school is Greensboro Academy

Required

What is your child's First Name (or name he/she goes by)? *

What is your child's Last Name? *

What is Parent 1's name? *

What is Parent 1's email address? *

What is Parent 1's cell phone number? *

What is Parent 2's name (if applicable)?

What is Parent 2's email address?

What is Parent 2's cell phone number?

What email address is associated with your paypal account? List all that may apply. *

What is the child's address? (Please list all that apply.) *

Please write the name of an emergency contact we may reach if you are not able to be contacted. *

Please give the emergency contact's cell phone number. *

Please write the name of an additional emergency contact. *

Please give this person's cell phone number. *

What grade is your child in? *

Does your child have any allergies? *

Yes

If your child does have allergies, please list them here:

Does your child take any medications? *

Yes

If your child does take medications regularly, please list them here:

I agree to adhere to the payment schedule as prescribed in the payment worksheet. Failure to make payment will result in a $20 fee. Returned checks will be assessed a $10 fee. Late pick-up (after 6:00 pm) will be assessed a $5 fee for the first occurrence, $10 with the 2nd occurrence, and $10 with a conference with the Director for the 3rd occurrence. Each child will be held to maintain the school standards of behavior within our program. Discipline issues will be handled on a case-by-case basis at the Director's discretion. I acknowledge and represent that I have read, understand, and accept all terms stated in this document as they relate to KJ Afterschool, LLC. By checking the box below, I agree to adhere to all policies, agreements, waivers and procedures of KJ Afterschool, LLC. *

I Agree

Thank you for completing your registration information! Now, please go to our website: https://kjafterschool.wixsite.com/happykids Click on the "Pay Now" Button to pay the $55 registration fee PER CHILD. This payment covers the registration fee and the cost of the first short week of school. Payments may be made by credit, debit or PayPal. *

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A copy of your responses will be emailed to the address you provided.

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