Bay Laurel Homework Club Registration Form
Thank you for your interest in Bay Laurel's Homework Club! To register your child for Homework Club, please complete the form below.

Remember, if school is open, WE ARE OPEN! Homework Club is open 5 days a week until 4:00PM.
--Mon/Tue/Thu/Fri: 3:00-4:00PM (price includes supervised care from 2:17-3:00PM for grades 1-3)
--Wednesdays: 1:30-2:30PM (price includes supervised care + lunch period from 12:36-1:30PM)
--After care option for Wednesdays: 2:30-4:00PM
--Homework Club hours are adjusted accordingly for Minimum Day Schedule

PRICING (per 4 week period):
--1 day/week = $100
--2 days/week = $125
--3 days/week = $150
--4 days/week = $175
--5 days/week = $200
--After Care (Wed. only) = +$60 to any option

--Donna Ouaknine (805) 338-1967
--Debbie Dreiman (818) 277-8776

Email address *
SECTION 1: Student/Parent Info
Student's Name *
Your answer
Grade & Teacher *
Parent/Guardian Name *
Your answer
Home Address (incl. City/State/Zip) *
Your answer
Untitled Title
Please provide at least one phone number
Cell Phone # *
Your answer
Home Phone #
Your answer
Work Phone #
Your answer
My child will attend Homework Club on the following days: *
I would like to add the extra 1.5 hours on Wednesdays, extending pick up time until 4:00PM *
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