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7-12 After Care Registration Form

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

After Care service is provided from August 22, 2022 through May 25, 2023 (Please note: there are some dates excluded).

Available on Regular Days (3:15-6pm) and Early Dismissal Days (11:45am-6pm).

*After Care will NOT be available for ALL grades during the first week of school (August 17-19, 2022) as those are 1/2 days and pick-up at 11:45am is required.*

Parent Information

First Name*

Answer Required

Last Name*

Answer Required

Email*

Answer Required

Phone (Best/Most Reliable)

Number Required

Student Information

First Name*

Answer Required

Last Name*

Answer Required

Grade*

Answer Required

7th

8th

9th

10th

11th

12th

Number of Days / Week*

Monthly payments are made from September 2022 - May 2023 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

Staff Student

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 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.

Please enter name below as your electronic signature*

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Confirmation Email

Email Required