Holiday Care Form
January 2nd-4th, & 7th
*Holiday Care will be held if 10 or more registered students sign up.
*This form must be completed and submitted by December 14th for Early Registration of $45. After the previously stated deadline, the amount will be $60 per child per day for Holiday Care.
Child's Name: *
Your answer
Grade *
Date(s) of Care Needed *
January 2nd
January 3rd
January 4th
January 7th
Dates:
Name of Emergency Contact for the Day: *
Your answer
Phone Number of Emergency Contact: *
Your answer
If your student it NOT currently registered in Before or Aftercare, please list approved adult names for the pickup of the child.
Your answer
Known Allergies: *
Your answer
I understand this form must accompany a payment of $45.00 per day per child and an additional $15 fee per day per child will be included if the form is not completed by the given due date. By typing your first and last name on this contract indicates acceptance of the above items. *
Your answer
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