2026-2027 Extended School Care Registration

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Student's Full Name *

Student's 26-27 Grade *

Time Selection *

Mornings (7-8 am; $50 per month)

Wednesday afternoons (2:30-3:35 pm; $30 per month)

Early Afternoons (pick up before 4:30 pm; $100 per month)

Extended Afternoons (pick up before 6 pm; $175 per month)

Full Time (both mornings and extended afternoons; $225 per month)

Mornings & Early Afternoons (7-8 am & 3:35-4:30 pm; $150 per month)

My student is at least 3 years old and completely potty trained. (Please initial) *

I understand my child will need a snack if staying for afternoon extended school care. (Please initial) *

I understand that if I do not pick up by 6 pm (or 4:30 pm for early afternoon registratns), a late fee of $10 + $1 per minute is applied. (Please initial) *

I understand Extended School Care is a privilege. Students are expected to abide by the LCA Code of Conduct. Serious behavior issues or repeated late pick-ups may result in dismissal from the ESC program. (Please initial) *

Person completing this form (full name). *

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