TK-6 After Care Registration Form

Please complete the form below. Required fields marked with an asterisk *

After Care service is provided from August 17, 2020 through May 27, 2021 (TK & K) or May 28, 2021 (1st-6th Grade). (Please note: there are some dates excluded). After Care is available beginning August 17-19, 2020 11:45am-6pm (TK & K) and 3-6pm (1st-6th Grade).

*After Care will NOT be available for ALL grades during the first week of school (August 12-14, 2020) as those are 1/2 days and pick-up at 11:45am is required.*

Regular Days (3–6pm), Early Dismissal Days (11:45am-6pm), Teacher In-Service Days (7:30am-6pm)

Parent Information

First Name

Answer Required

Last Name*

Answer Required

Email*

Answer Required

Phone (Best and Most Reliable)*

Number Required

Student Information

First Name*

Answer Required

Last Name*

Answer Required

Grade*

Answer Required

Transitional Kindergarten

Kindergarten

1st

2nd

3rd

4th

5th

6th

Number of Days / Week*

Monthly payments are made from September 2020 - May 2021 through your FACTS account. A fee of $1 per minute will be assessed for parents arriving after 6pm. If you choose 3 Days/Week and exceed those days in any given week, you will be billed at the 5 Days/Week rate for that month. The registration fee is $50 per student for After Care registration.

Answer Required

3 Days / Week (monthly payment = $205) + Registration Fee

5 Days / Week (monthly payment = $300) + Registration Fee

*After Care is only available on Early Dismissal Days & Teacher In-Service days for those students who are registered for the 3- or 5-day program.*

After Care on the Lower Campus is available in an emergency at a flat rate of $35.00 for one-time-use/student. One-time emergency usage does not apply to Early Dismissal or Teacher In-Service Days.

Security Code (NOT Activated until after COVID passes)* Please provide a 4-digit security code to use the keypad. The key pad is located at the side entrance of the school. You will have access at these doors from 3-6pm (Regular School Days), 11:45am–6pm (Early Dismissal Days), or 7:30am-6pm (Teacher In-Service Days). You must hit the # key after you put in your four digit code in order to gain entry to the building. Your code will be effective the first day of After Care. Please do not share your security code with your child or other people. *This code will NOT BE ACTIVATED until access to the building is permitted after COVID.**

Please enter a number less than or equal to 9999.

Answer Required

I understand that I am registering my child for After Care. I have indicated my choice for the registration fee and the number of days above. I have reviewed the list of days that After Care is closed. I understand that my agreement to comply with the stipulations of the GRACE Statement of Cooperation will also pertain to the GRACE After Care program. I understand that my FACTS account will automatically be billed monthly if I use After Care.

Signature (Enter first and last name below)*

Answer Required

Please fix the highlighted areas below before submitting.

TK-6 After Care Registration Form