Extended Day Application

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Extended Day Information/Rules
- Hours = 7:00-7:40 am & 4:00-5:00 pm
- Students must be picked up by 5:00 pm (3 late pickups = not allowed to participate in the extended day program) Parents will be charged $20 if you are 15 minutes late to pick up your child or if your child is staying and you are not approved for the program.
- Cost: Free
Who can participate?
- Only TEAM families that fill out the application below and qualify for the Extended Day Program will be allowed to stay. Families must prove that they cannot drop off after 7:40 AM and/or pick up their child by 4:00 pm because all adults in the household are working.
- Only TEAM students are allowed at Extended Day (no older/younger siblings).
- Once you are approved, you will fill out a form with emergency contact information and who is allowed to pick up your child from extended day.
Behavior
- Students are expected to follow Extended Day Rules. (Any act of physical aggression, 2 Major Referral Forms or 4 TOTAL Referral Forms = not allowed to participate in extended day program)
- Students are expected to participate in a quiet activity (read, do homework, color, computers, movie, etc.)
Daily Procedures - changed from last year - we are limiting visitors in the building this year
- Drop off - Please drop your child off at the gym door and a staff member will meet them there
- Pickup - Please pull up to the main doors and a staff member will send your child out.
- No more than 15 students will be together at a time. We will use the gym and media center to space students out for the extended day program.

Please fill out if you if you want your child to participate. Parents will be notified by the Director if they qualify for the Extended Day Program.

Student's First Name *

Student's Last Name *

Student's Grade *

I need to drop off my child before 7:40 AM because of our work schedules.

Yes

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I need to pick my child up after 4:00 PM because of our work schedules.

Yes

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Please list all adults in the household, their workplaces, and work hours.

We agree to follow the Extended Day rules. I understand that if my child breaks any of the above rules they can no longer attend Extended Day. I also understand that the school may contact my employer to verify information on this application.

Yes

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