Extended Care Registration 2018/2019
Have you used our Extended Care program previously?
New to Extended Care this year
Returning to Extended Care
Mother's first and last name:
Father's first and last name
The primary household email address for the family, which will receive important notices from our program.
We will be using Extended Care for:
Please check all that apply
Morning Care (6:30 - 8:00am)
Afternoon Care (2:50 - 6:00pm)
Occasional Use Only
Persons other than you who are authorized to pick up your children
Please include the full name and relationship to your child(ren).
Family ID #
This can be found in your FACTS family profile, and it is also the same as your church envelope number, if you are registered with St. Juliana Parish. If unsure, please leave blank.
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