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Kids' Club November Half-Day Extra Care Registration Form ~ Deadline 11/2/17
Thursday, November 16, 2017
Friday, November 17, 2017
Wednesday, November 22, 2017

Elementary students have a half-day of school. Extra Care is available from 12:15 p.m. - 6:00 p.m. by completing this registration.
Cost: $33.00 per Afternoon

Parent pick up required.
Children must bring a bag lunch with drink.

DEADLINE to Register for November Half-Days: Thursday, November 2, 2017.
Late registrations may be accepted (space permitting) and will incur a $10.00 late fee.
CANCELLATIONS after November 3 through November 9, 2017 will incur a $10.00 fee.
Email cancellation to
Cancellations after November 9, 2017 will not be accepted.

Child's First Name *
Your answer
Child's Last Name *
Your answer
Attends Kids' Club at: *
Grade *
Does child have a dietary restriction? *
Extra Care needed on:
Parent email address *
Your answer
I understand $33.00 per afternoon for which I have registered will be added to my next invoice. *
Parent Signature *
Your answer
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