2023-2024 Warren County R-III Latchkey Enrollment Form
Please submit a separate form for each child.  Please enroll your child even if they were enrolled during the 2022-2023 school year.

Please note there will be a $25.00 enrollment fee for the 2023-2024 school year.  

2023-2024 Rates:  https://docs.google.com/document/d/1QmrU2u1VBfit8T80tXzyDLa21sv1sKDHf9CqGiPyeMs/edit?usp=sharing


1.  I understand that the latchkey program is open according to the official school calendar of the Warren County R-III schools and is closed during vacations and inclement weather.

2.  I understand that I am responsible for the payment of fees weekly, which is due each Friday.  If payment is two weeks past due your child/children will be dismissed from the program until the account is paid in full.

3.  I understand that I am responsible for signing my child/children in/out each time my child attends the program.  (No drop-offs)

4.  I will update my child's information as outlined in the Parent Handbook. I will notify the Latchkey Staff if someone other than the persons listed on the enrollment form is to pick up my child.  The person picking up the child will need to have a form of ID when signing the child out of the facility.

5.  Parents must notify the school office and Latchkey Staff by 1:00 PM either by phone or a signed note of any daily changes in the child's latchkey schedule.

6.  If a medical emergency arises, the Program Staff will first attempt to contact me.  If I cannot be reached, the staff will contact the emergency persons listed on the enrollment form or contact the child's doctor.  If the emergency is such that immediate attention is necessary, an ambulance or emergency vehicle may take my child to the nearest hospital.

7.  I agree to have my child abide by the discipline rules outlined in the Parent Handbook.  "Action will be taken to those who do not follow the rules."

8.  The Latchkey Program opens at 5:30 AM and closes at 6:00 PM PROMPTLY.  If you cannot be here by that time, please make arrangements for someone to pick up your child/children.  A $1.00 per minute charge will be added to your account for every minute after 6:00 PM.

9.  An afternoon snack will be provided for the students attending the program.

Filling out this form DOES NOT mean your child will be able to attend Latchkey immediately. You will receive a Notice of Acceptance email when you are processed and ready to start. YOU MUST RECEIVE A CONFIRMATION EMAIL BEFORE YOU CAN BEGIN.


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Email *
Child's name *
Birthdate *
MM
/
DD
/
YYYY
Gender *
What grade is your child currently in? *
Required
Latchkey will be located in your child's building of attendance.  Please mark the building that your child currently attends. *
Required
Child's Address *
Parent 1:
Parent /Guardian Name:
 *
Phone Number *
Parent/Guardian Address *
E-mail Address *
Employer *
Employer Address *
Work Phone Number *
Work Schedule (Days and Time) *
Parent 2
Parent/Guardian Name:
Phone Number
Parent/Guardian Address
E-mail Address
Employer
Employer Address
Work Phone Number
Work Schedule (Days and Time)
1st Emergency Contact (Name and Relationship to the child) *
1st Emergency Contact Phone Number *
1st Emergency Contact Address *
2nd Emergency Contact (Name and relationship to the child) *
2nd Emergency Contact Phone Number *
2nd Emergency Contact Address *
Please list any health conditions, medications, or allergies, including chronic health problems (such as asthma) that we need to be aware of for your child. *
Child's Doctor's Name and Phone Number *
Preferred Hospital (Name and Phone Number) *
What sessions will your child attend Latchkey? *
I have read the Warren County R-III School District's Latchkey Handbook (link below). https://docs.google.com/document/d/1XpTDAe-JgcG1ehqica_2LRJdgaznejVm/edit?usp=sharing&ouid=105591176258302581722&rtpof=true&sd=true

 *
Required
I agree to adhere to the stated policies and procedures of the Latchkey Program as stated here and in the parent handbook.  I give my child permission to participate fully in this program. *
Required
This also serves as an enrollment agreement that you agree to pay for services provided by the Warren County R-III Latchkey Program.
Acknowledgements

I have been informed that a copy of the licensing rules for child care homes or the licensing rules for group child care homes and centers is available at this facility for review.
 *
Required
The provider and I have agreed on a plan for continuing communication regarding my child's development, behavior, and individual needs. *
Required
When my child is ill, I understand and agree that she/he may not be accepted for care or remain in care. *
Required
I understand that, before the first day of attendance by my child, I will provide proof of completed age-appropriate immunizations or exemptions from immunizations. *
Required
I give permission for field trips/excursions.  I understand I will be notified in advance when they are planned. *
I give permission for the facility to transport my child. *
I have been notified that I may request notice at initial enrollment or any time there after whether there are children currently enrolled in or attending the facility for whom an immunization exemption has been filed. *
Required
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