2023-2024 Spartan Afternoon Academy-Bentonville
After School Academy will be from 2:45pm-5:30pm Monday through Friday.
Cost: $65 a week.  Please note this is regardless of attendance. 
*Weekly payment is due each week on Monday.  Tuesday morning a $10 late fee will be assessed on accounts in arrears.  
 
*Please fill out a separate form for each child being enrolled.  
*If you are enrolling a student for the first time, there is a $50 nonrefundable registration fee due the first week of school.  

Email katshipman@responsiveedar.com

*K-12 Payment system online. Cash not accepted
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Email *
Student Name *
Birth Date *
MM
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DD
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YYYY
Grade *
Gender *
Name of siblings also attending Afternoon Academy *
1. Parent/Guardian Name *
1. Parent/Guardian Phone Number *
2. Parent/Guardian Name *
2. Parent/Guardian Phone Number *
2. Parent/Guardian Email *
Emergency Contact Name *
Emergency Contact Phone Number *
I understand that there is a penalty fee of $1/minute for anyone being picked up after 5:30. *
Required
I understand and agree to  pay $65 weekly regardless of attendance. *
Required
Please list any other adult allowed to pick up besides parents: *
Please list any health concerns we need to know: *
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