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AFTER SCHOOL CARE REGISTRATION 2020 SY
ONE FORM PER STUDENT: May Sands Montessori School offers extended child care, after the school day, to currently enrolled students from 3:30 P.M to 5:30 P.M. Payment is due before your child's/children's first session at After School Care. To pre-register please complete the Registration Form (by clicking on the link below) and bring your payment to Pam Niles at May Sands Montessori School. We accept payment in form of debit/credit card, cash, or check made payable to May Sands Montessori School.
Daily pre-paid: $12 per day
Weekly pre-paid for the entire week: $50 per week
Drop-in rate: $15 per day due at the time of pick-up
Sibling discount: $5 per day per additional sibling
Student name (Last, first):
Student date of birth (dd/mm/yyyy):
Student grade level:
Does your child have any physical disabilities, limitations, or allergies? YES or NO (if YES please explain):
Does your child require any medicines? YES or NO (if YES please explain):
Student's physician name & phone number:
Primary parent/legal guardian - full name, address, and phone number/s:
Secondary parent/legal guardian - full name, address, and phone number/s:
The following individual/s are authorized to pick up my child - please list full name & all phone numbers:
RELEASE AND WAIVER OF LIABILITY: I give permission for the staff of MSMS (May Sands Montessori School) After School Care program to provide any medical assistance they feel appropriate for my child named above. I also give permission for any emergency personnel to treat my child in the event of an emergency. In consideration of the right to participate in the MSMS After School Care program, I for my minor child, and myself, have and do hereby assume all risks and will indemnify and hold harmless the MSMS After School Care program and its staff, their employees, board members, officers volunteers, and any members from any and all liability.
I hereby grant the release stated above
I do not grant the release above
Additionally, I give permission for my child to leave the MSMS campus with the staff of the MSMS After School Care program for short excursions in the neighborhood to include Bayview Park and Dairy Queen. I give also give permission to the MSMS to use any and all pictures taken to be used in publications, including web publication. All pictures and videos will become property of the MSMS. PARENT/LEGAL GUARDIAN FULL NAME & DATE:
Send me a copy of my responses.
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