School Programs Application
FEE/PAYMENT/LUNCH/CANCELLATION POLICY

Fees are $5.00 per student for a 1.5 hour preK program, $7.00 per student for a 2-3 hour half day program, $10.00 per student for a 5 hour all-day program and $12.00 per student for two different half-day programs. There is no charge for up to 10 chaperones. The program fee will be applied to any extra chaperones if more than 10 attend.

• Payment must be received at least two weeks prior to the scheduled class date. No refunds will be given under $20.
• You are welcome to eat lunch at Riveredge before or after a program. Lunch fees are $10 for 20 students or less, and $15 for more than 20 students. There is no charge for lunch during an all-day program or two half-day programs on the same day.

Which school year are you applying for? (e.g. 2019-2020) *
Your answer
Season: *
Required
Contact Teacher Name: *
Your answer
Contact Teacher Email Address *
Your answer
Contact Teacher Cell Phone Number *
In the event we need to contact you the day of the program, before your school opens (Due to cancellation, emergency weather conditions, etc.)
Your answer
Additional Classroom Teachers:
Your answer
Additional Classroom Teacher Emails:
Please list contact information for all teachers who will be bringing students separated by a comma.
Your answer
Name of School: *
Your answer
School Address (#, street, city and zip code): *
Your answer
School Phone Number: *
Your answer
School County: *
School District: *
Your answer
Grade: *
Your answer
Number of classes: *
Your answer
Total Number of Students: *
Your answer
Please include all specific learning and/or accessibility needs (i.e. mobility, allergies, sensory):
Your answer
Indicate dates that affect scheduling (vacations, last day of school, etc.): *
Your answer
Onsite Programs (At Riveredge)
On-site Program 1st Choice
On-site Program 2nd Choice
Outreach Programs (At your School)
Please note that there is an additional $30 mileage fee for outreach programs.
Outreach Program 1st Choice
Outreach Program 2nd Choice
Any Program Choice Comments?
Your answer
Please tell us your learning objectives, if any:
E.g. Will this learning experience be introducing a concept or reinforcing one? How does it fall into your curriculum?
Your answer
Length of Program Preference: *
Earliest Arrival Time: *
Time
:
Latest Departure Time: *
Time
:
Morning or Afternoon Preference: *
Will you be bringing a bagged lunch? *
$10 facility fee for 20 students or less, $15 fee for more than 20 students
Is this your first time at Riveredge?
If yes, how did you hear about us?
Do you have any additional comments or concerns?
Your answer
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