K-8 Summer Child Care
PLEASE USE THIS FORM if you need child care services for children who have completed Kindergarten and older.

If you are not enrolled at ASA for the 2017-18 school year, you will be assessed a $100.00 registration fee.

Child 1 - First Name:
Your answer
Child 1 - Last Name:
Your answer
Child 1 - Grade for 2017-18 school year:
Your answer
Child 2 - First Name:
Your answer
Child 2 - Last Name:
Your answer
Child 2 - Grade for 2017-18 school year:
Your answer
Child 3 - First Name:
Your answer
Child 3 - Last Name:
Your answer
Child 3 - Grade for 2017-18 school year:
Your answer
Will your family need child care services between June 12th and August 25th?
Will your family have children in our Early Childhood summer child care program?
What days will your child be attending?
Required
Dates of planned vacations if known:
Your answer
What email(s) would you like us to use to contact you about summer happenings?
Your answer
Anything you would like to share with us?
Your answer
Submit
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