SJS After School Programs Registration Form
Session Dates:January 21, 2020 - May 29, 2020
Email address *
Student Last Name *
Your answer
Student First Name *
Your answer
Grade *
Homeroom Teacher
Your answer
Parent/Guardian Name *
Your answer
Contact Number *
Your answer
Emergency Contact Name (other than parent) *
Your answer
Emergency Contact Number *
Your answer
(other than parents) Alternate individuals authorized to pick up your child (please indicate name & contact #s) limit to 2 individuals *
Your answer
Individual Tutoring
Please fill out the following information for individual tutoring only. Individual tutoring is one student to one teacher at $50 per hour. Starting at 4:00 p.m.
Please select which day or days of the week you wish your child to attend tutoring.
If you would like your child to focus on a specific subject or subjects, please indicate them here:
Music Lessons
Please fill out the following information for private music lessons only. Each lesson is 30 minutes long and $35 per lesson. Please visit our website and follow the link to a list of the after school music teachers and their contact information. Starting at 4 pm.
For music lessons only. Please select which day of the week you would like.
Please indicate the type of instrument and skill level. (Violin, Viola, Cello, Guitar, Piano, Ukulele, and Drums) and (Beginners or Intermediate Level)
Your answer
Group Classes
Please indicate which class or classes you are interested in. All classes start on the week of August 26 and the last day of classes will be December 19. Tuition will be prorated for any registrations received after August 26.

Group classes may range anywhere from 6 - 15 students. If a class is canceled due to insufficient enrollment, parents will be notified via email and assisted in finding an alternative class if available. If a class is full, you will be notified, placed on a waiting list, and contacted if space becomes available. PreK-4 students may only enroll for the Monday Computer class and Tuesday Art class.
After-school Care
After-school Care is available for students in PreK - 3rd grade. After-school care is located in LS 1 (Dance Room). Hours are from 4:00 pm - 5:45 pm. Parents will be charged a late fee of $1.00 per minute after.
Registration and Payment
Tuition payment must be paid in full prior to student's first day of class.
Tuition will be prorated for any registrations received after August 26.

Please select one of the following payment menthods. *
General Registration Information
• Registration will be available January 14, 2020.

• Registration for all After School Programs and/or After School Care must be completed on this form. You will receive a personal confirmation within 2 business days after registration.

• You will be contacted with information on the available instructors and final schedule.

• Courses cannot be dropped or changed online. Please email for any concern.
Policies and Procedures
*Attendance - It is a necessity that we know the whereabouts of the students enrolled in the program. Attendance will be taken daily. It is the responsibility of the student and/or parent to notify the tutor of absence(s) on/before 12 noon of the scheduled day in order to schedule a make-up session. No make-up sessions for absences are applied for group classes, unless special arrangements are made with the instructors. Tutors will be held to the same expectation of informing clients of their absences.

*After School programs are not provided on holidays, vacations, early dismissal days, or other school days off. Please see our School Calendar for a list of holidays and early dismissal days.

*Should inclement weather or emergency campus closure occur, classes will be rescheduled automatically.

*Students are expected to arrive on time and prepared to learn. Tutor & group instructors will retrieve ALL students from LS 11 on the day of tutoring or group classes.

*Parents and Guardians are expected to pick up students immediately after their tutoring session is over from the their after school class. After the class is done parents will be given a 5 min. grace period to pick up their child. Afterwards, students in PREK4 - 2 grade will be brought to the aftercare classroom where a $10 fee will be charged once arrived (and per hour thereafter) and ALL 3rd-5th graders & MS/US students will be released to the library. Students will NOT be released to an unauthorized individual.

•If an individual who is not on the authorization list is picking your child, you must email the ASP coordinator informing them of the change and the individual MUST present a valid ID.

• Credits for fees paid will not be applied if the attendance policy for absences has not been followed and/or for other reasons like planned vacations after confirmation of your child's schedule has been sent and fees are paid in full.


*All students registered for swim class must fill out a swim waiver form and submitted to the main office. Once the student is enrolled in the swim class, ASP coordinator will email swim waiver form.

*All students in swimming class must be picked up at the pool. Parents will be given a 5 minute grace period after lesson time has ended. A $1/minute charge will be incurred thereafter.

A copy of your responses will be emailed to the address you provided.
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