Extended Care Order Form
Fill out this form by Friday of each week for the following week. Cost for extended care is $5 per hour from 3-5 PM (& $10 per hour after 5 PM)
Parent Name
Child(ren)'s Name(s)
What grades are they in?
What days will they need extended care (from 3-5:00 PM)?
Current location of child?
Any additional clarifying information?
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