After School Reg Form 1

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After School Program

STEP #1: Complete This Short Form

After School Enrollment

To register, please take the time to fill out the information below.

Your Full Name

Child's Full Name

Your Email

Phone

Child's Birthday

Address

List Any Allergies Here

Select a Start Date

School Name

I Am Interested In

Full Time $80/wk (5 Days/Wk)

Part Time $75/wk (4 Days/Wk)

Part Time $70/wk (3 Days/Wk)

Part Time $60/wk (2 Days/wk)

Registration Fee ($40/child)

Undrstandings

I understand that in order to retain my child's spot in the program, I am required to pay weekly the tuition regardless of breaks, holidays, and school closures. With the exception of 1 Free Week redeemable if my child doesn't attend day camp during Spring Break. And 1 Free Week For Christmas Winter Break. Fall/Thanksgiving Break is still charged regardless of attendance.

I will do my best to encourage my child to follow The 3 Rules 2 Rock Code Of Conduct: 1. Respect 2. Participate 3.Have a positive attitude

I understand that my child has to be picked up before 6pm. Anything past that time costs $1 min payable the same day.

I understand that snack is provided daily during the after school program however meals and snacks are not included during school breaks/closings. I can opt in to the extended care for an additional $45 and this includes snacks and lunch.

I understand tuition is due on Fridays the week before my student attends. Anything past Friday will be charged a $10 late fee. The tuition is the same amount weekly regardless if school opens or not. Some minor Holidays Rock Zone will closed and the rate is not discounted or pro-rated.

As a safety measure for everbody in the program I understand that if I or my child repeatedly break set rules we could be suspended or asked to leave from the program.

My Child Has An IEP (If yes we require a copy of the most recent IEP)

Yes

No

If your Child has an IEP does he/she require an aide?

Yes

No

Has your child ever been suspended or expelled from another After Care program?

Yes

No

STEP #2: Fill Out The Long Form On Or Before The 1st Day Your Child Attends

LONG FORM CLICK TO DOWNLOAD