JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Spring 2021 Care Request/Waitlist
You will need to complete 1 form per child.
*THIS IS NOT A REGISTRATION*
If we get enough kids (and we have enough space) to offer a partial care schedule we will be reaching out to you!
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Parent/Guardian Name
*
Your answer
Email
*
Your answer
Cell/Phone Number:
*
Your answer
Child's Name
*
Your answer
Child's Grade
*
Choose
K
1
2
3
4
5
KAH Location
*
Choose
Barnsley
Burtonsville
Bayard Rustin
Cannon Road
Carderock Springs
Cloverly
Fairland
Farmland
Flora Singer
Flower Valley
Forest Knolls
Garrett Park
Glenallan
Greencastle
Highland View
Kids After Hours Office
Meadow Hall
North Chevy Chase
Oakland Terrace
Page
Rock View
Rosemary Hills
Westbrook
Westover
Woodlin
Which Partial Schedule would you like?
*
Below our the options we are hoping to offer soon.
AM Only + Wednesday - $130 per week
PM Only + Wednesday - $140 per week
A/B (Before/After/+ Wednesdays for IN-PERSON Week) - $175 a week
A/B (Before/After/+ Wednesdays for VIRTUAL Week) - $300 per week
AM ONLY (no Wednesdays) - $85 per week
PM ONLY (No Wednesdays) - $125 per week
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Kids After Hours.
Report Abuse
Forms
