Kindergarten Extended Day Contract
2023-2024
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Student Last Name *
Student First Name *
Before Care begins at 7:30 am and is for any child dropped off before 8:05 am.  My child will attend Before Care on:
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My child will attend Monday Afterschool Care.  The pickup time will be:
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My child will attend Tuesday Afterschool Care.  The pickup time will be:
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My child will attend Wednesday Afterschool Care.  The pickup time will be:
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My child will attend Thursday Afterschool Care.  The pickup time will be:
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My child will attend Friday Afterschool Care.  The pickup time will be:
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Parent Name *
Parent Phone Number *
Parent Name
Parent Phone Number
Authorized Pickup Other Than Parent
Phone Number for Authorized Pickup Other Than Parent
Authorized Pickup Other Than Parent
Phone Number for Authorized Pickup Other Than Parent
Does your child have any allergies? *
If you said yes above, please describe the allergy and the protocol for care.
I give my approval for my FACTS Account to be charged.  Please type parents full name below to indicate your approval of these charges *
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