Extended Care 2022-2023 Contract
Please use the form below to enroll your child in the Extended Care program for the 2022-2023 school year. You do NOT need to fill out a contract for drop-in use.

The fee for drop-in use is $10 per day for Extended Care before school (AM Care).

The fee for the drop-in rate is $15.00 from 3:15-4:00, $15 from 4:01-5:00, $15 from 5:01-6:00 for Extended Care after school (PM Care).

Extended Care drop-in charges are released after the month has concluded, and the charge must be paid within 30 days of the invoice to avoid any interruption in care.

Extended Care contractual charges can be billed/broken down in three ways: Yearly, Semester, Monthly

Extended Care contracts can only be changed at semester per the contract.
Sign in to Google to save your progress. Learn more
Email *
Student First Name *
Student Last Name *
Student Grade Level (PS-5) *
Student Classroom Teacher
AM Care- $1,200 - If you are enrolling your child in Extended Care before school, please select the before care option below (annual fee):
PM Care - Five Days - If you are enrolling your child in five days of Extended Care, please choose one of the following enrollment options.
Four Days - $3,265.00 - The cost for your child to attend Extended Care for four days a week from 3:00-6:00 is $3,2650.00. If you are enrolling in four days a week, please indicate what days your child will attend.
Three Days - $2,450.00 - The cost for your child to attend Extended Care for three days a week from 3:00-6:00 is $2,450.00. If you are enrolling in three days a week, please indicate below what days your child will attend.
Two Days - $1,630.00 - The cost for your child to attend Extended Care for two days a week from 3:00-6:00 is $1,630.00. If you are enrolling in two days a week, please indicate what days your child will attend.
One Day - $840.00 - The cost for your child to attend Extended Care for one day a week from 3:00-6:00 is $840.00. If you are enrolling in one day a week, please indicate below what day your child will attend.
Payment and Confirmation
By typing your name and the date in the fields below, you are agreeing to pay the Extended Care fees listed above to the Barstow School. You have the option of paying annually, by the semester or by the month. If you have any questions, please contact Max Williams at max.williams@barstowschool.org or 816-277-0429.
Extended Care charges will be added to your bookbill. Please indicate the method you would like to be billed. *
Required
Signature (Parent/Legal Guardian) *
Date *
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of The Barstow School. Report Abuse
Google Forms