Kids' Club January Half-Day Extra Care Registration Form ~ Deadline 1/11/19
Friday, January 25, 2019:

Elementary students have a half-day of school.
Extra Care is available from 12:15 p.m. - 6:00 p.m. by completing this registration.
Cost: $33.00 per Afternoon.

Parent pick up required.
Children must bring a bag lunch with drink.

DEADLINE to Register for January Half-Day: Friday, January 11, 2019.
Late registration may be accepted (space permitting) and will incur a $10.00 late fee.
CANCELLATIONS after January 11 through January 18, 2019 will incur a $10.00 fee.
Email cancellation to:
Cancellations after January 18, 2019 will not be accepted.

Child's First Name *
Your answer
Child's Last Name *
Your answer
Attends Kids' Club at: *
Grade *
Does child have a dietary restriction/ *
Extra Care needed on: *
Parent Email address: *
Your answer
I understand $33.00 per afternoon for which I have registered will be added to my next invoice. *
Parent Signature *
Your answer
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