HN Extended Care Form (Afternoon ONLY)
The Extended Care Program is open to all boys and girls, kindergarten through 8th grade who need a daily program after school.

AFTER SCHOOL CARE
Our After School program is available immediately following dismissal. Your child can participate in art activities, outdoor recreation, quiet time for homework, and snack time.

Full Time Fee : $250.00 monthly. Siblings are charged $200.00 each monthly.
Part Time/Drop-In Fee : $25.00 on regular dismissal days, $35.00 on early dismissal days.

Families will be charged monthly via their FACTS accounts.

Late Fee : The After School program is open until 6:00 pm. If your child is picked up after 6:00 pm, there is a $25.00 late charge. If your child is picked up after 6:30 pm, there is a $50.00 late charge.

The After School program is directed by Alcira Bermudez. Mrs. Bermudez is available on site, abermudez@holynamesf.com, or at 415-564-2632.
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Email *
Family's LAST Name *
I am enrolling the following child/children in the After School Extended Care Program. I understand that my fees will be added to my FACTS account. *
Required
Child #1 FIRST NAME *
Child #1 LAST NAME *
Child #1 GRADE for the 22-23 school year *
Child #1 Medical Conditions or Allergies
Child #2 FIRST NAME
Child #2 LAST NAME
Child #2 GRADE for the 22-23 school year
Child #2 Medical Conditions or Allergies
Child #3 FIRST NAME
Child #3 LAST NAME
Child #3 GRADE for the 22-23 school year
Child #3 Medical Conditions or Allergies
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