EXTENDED DAY AM and PM SUPERVISION PROGRAM SIGN-UP FOR THE 2018-2019 SCHOOL YEAR
Rochester Catholic Schools offers Extended Day AM and PM Supervision Programs at Holy Spirit Catholic School, St. Francis of Assisi School; and St. Pius X School and Extended Day AM at St. John the Evangelist for students in grades kindergarten through grade eight. Extended Day AM runs from 6:30 am - 8:20 am and Extended Day PM begins after school until 6:00 pm. Now is the time to sign up if you will need this service for the 2018-2019 school year. You will have the option to utilize the service every-day, specific days per week, or on a drop in basis. The fee for the Extended Day AM Supervision program is $8.00 per day/per student and fee for the Extended Day PM Supervision is $10.00 per day/per student. There will be a $10.00 late fee for every five minutes that students are in the Extended Day PM program after 6:00 pm. There will be an Extended Day All Day program available on November 2nd at a cost of $29.00 per child for this day. Staffing is determined by the number of students signed up by May 4, 2018. Please use this form to sign up by May 4, 2018. Look for new billing options to come in the near future!
Email address *
Family Name *
ex: Smith
Your answer
School Attending *
Required
Child 1 Name *
Lastname, Firstname
Your answer
Child 1 Grade Level for the 2018-2019 School Year *
Child 2 Name
Lastname, Firstname
Your answer
Child 2 Grade Level for the 2018-2019 School Year
Child 3 Name
Lastname, Firstname
Your answer
Child 3 Grade Level for the 2018-2019 School Year
Child 4 Name
Lastname, Firstname
Your answer
Child 4 Grade Level for the 2018-2019 School Year
Mother's Name
Lastname, Firstname
Your answer
Mother's Home Phone Number
Your answer
Mother's Work Phone Number
Your answer
Mother's Cell Phone Number
Your answer
Mother's Email Address
Your answer
Father's Name
Lastname, Firstname
Your answer
Father's Home Phone Number
Your answer
Father's Work Phone Number
Your answer
Father's Cell Phone Number
Your answer
Father's Email Address
Your answer
Name(s) and contact information to call in an event a parent(s) cannot be reached. *
Your answer
Are there any health concerns for students attending the Extended Day Programs?
(please list information for each student - name and health concern)
Your answer
In the event an ambulance would need to be called I authorize RCS to have my child(ren) taken to
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