Playsafe Summer Schedule

        Week Dates:________________________________                                                Prices:         First Child                       Each add. Child

                                                                                                                Full Day - $25.00                $21.00

                                                                                                                Half Day - $18.00                $15.00

        

        First Child’s Name_____________________________

                                Monday         |        Tuesday        |        Wednesday        |        Thursday        |        Friday

        First Child        Arrival____________        Arrival____________         Arrival____________         Arrival____________         Arrival____________ TOTAL DAYS________

PickUp___________        PickUp___________        PickUp___________         PickUp___________        PickUp___________

                        

                        First child total-full days________________ X ($25.00) or half days___________ X ($18.00) = $____________

        Second Child’s Name__________________________

        

                                Monday         |        Tuesday        |        Wednesday        |        Thursday        |        Friday

            2nd Child         Arrival____________        Arrival____________         Arrival____________         Arrival____________         Arrival____________ TOTAL DAYS________

PickUp___________        PickUp___________        PickUp___________         PickUp___________        PickUp___________

Third Child’s Name__________________________

        

                                Monday         |        Tuesday        |        Wednesday        |        Thursday        |        Friday

            2nd Child         Arrival____________        Arrival____________         Arrival____________         Arrival____________         Arrival____________ TOTAL DAYS________

PickUp___________        PickUp___________        PickUp___________         PickUp___________        PickUp___________

                        2nd child total-full days________________ X ($21.00) or half days___________ X ($15.00) = $____________

                        Compute total cost for the week. Fill in blanks below:

                        Total for first child                $____________

                        Total for add. Children                $____________

                        Swim $3.00/child                $____________ (Thursday’s Only)

                        Total amount Due                $____________

                        

                        Options for Scheduling/Payment:                                Cash______________        Check#_____________

                                                                                        Credit Card #: _______________________________ Exp.______

                                                                                        CSV:______________        Billing zip___________

                        Mail Schedule Payment to:

                        SRAP&R        320 N. Main St. Slippery Rock, Pa. 16057

                        Email schedule to: srpark2@zoominternet.net and mail payment

                        Fax: 724-794-8181 and mail payment

                        Drop off @ Park office - DO NOT give to Playsafe Supervisor