Before and After Care Registration

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Please complete this form for EACH child you are registering for our program.
After this form is completed, a registration fee of $47.50 will be added to your Blackbaud Tuition Management account to be assessed in the next payment cycle (around the 20th of the month) Note that a 50 cent fee/day will be assessed for after school snacks.

Parent Information

Please provide us with the best information to reach you during the times your child(ren) will be in our before and/or after care program.

Family Last Name *

Mother's Name (Last, First) *

Mother's Cell Number *

Mother's email *

Father's Name (Last, First) *

Father's Cell Number *

Father's email *

Home address *

https://docs.google.com/document/d/1OqFKYyNimoxV2LXX9wi9BWzqAg6RVYIoFp3JifqksCs/edit?usp=sharing *

I hereby acknowledge that I have received and read the Before & After Care program handbook. I agree to promote the philosophy and abide by the policies and regulations stated in the handbook.

Required

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