Extended Care Registration Form 23/24
Before school care is offered from 7:00 am until 7:45 am when school is in session.(located on 3rd floor of Elementary  building)

Price for before school care:
$5 per day

After School Care is offered 3:00(2:00 Wednesday)pm until 6:00 pm when school is in session.

Price for after school care:
$20 per day
or
$75 when attending 5 days

Drop in care is also available: If you need drop in care for your child, please notify Shea-Leah Addenbrooke via email/call or text aftercare line not front office and your child's teacher. 

Any students remaining after 3:15 or 2:15(W) this time will be escorted to extended care and cared for until an authorized party arrives and charged for extended care after 3:15pm.

A charge of $1 per minute will incurred for any students remaining after 6:00pm.

Daily Snack will be provided at 330pm
Open to grades K-8
3:00pm-3:30pm(will be personal time)(child can work on homework/read/color/etc)

Questions may be directed to shea-leah.addenbrooke@mdcacademy.org. or call or text 352.933.4068
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Email *
Student Name First *
Student Name Last
 *
Grade Entering 23-24 school year *
Birthday *
MM
/
DD
/
YYYY
Allergies and/or special needs
Parent/Guardian #1 Name *
Parent/Guardian #1  Email: *
Parent/Guardian #2 Name
Parent/Guardian #2 Email
Please list additional adults authorized to pick up your child and Phone Number
Waiver:I hereby declare that my child is in good health and able to participate in the MDCA extended care.  I will not hold the MDCA Administration, faculty, staff, or volunteers liable in case of injury as a result of participation.  I hereby authorize the staff of MDCA to act on my behalf in the event that I cannot be contacted. It is understood that I will be fully accountable for any and all costs incurred in the treatment of my child. I have read and understand the payment schedule, conduct, dress code, medication, cancellation, and late pick-up policies, and I agree to abide by them. I give my permission for photographs of my child to be used in displays and advertising for the MDCA extended care. My signature below is consent to all the above. Please type your name as the electronic signature to the above after school waiver *
MDCA staff *
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