After-School Care Enrollment Form

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After-School Care Enrollment Form

Thank you for your interest in the After-School Care Program at UAP. Please fill out this registration form. The hours of after-school program are from 3:45pm - 5:45pm for grades 1 through 8, and from 2:45pm-5:45pm for Pre-K students.

Any student who has received disciplinary actions or suspended may not be able to attend the after-school program.

Email *

Student/s first and last name (Please add all students' names) *

Student/s Grade *

Pre-K

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

6th Grade

7th Grade

8th Grade

Required

Parent/Guardian first and last name *

Parent/ Guardian Phone Number *

Your relationship to the student *

Parent

Guardian

Authorized to pick-up

Emergency Contact Name *

Emergency Contact Phone Number *

Program Type *

One hour: 3:30PM - 4:30PM- ($325 per month)- Will be added to student's TADs account

Two hours: 3:30PM - 5:30PM- ($650 per month)- Will be added to student's TADs account

A la Carte (Irregular Schedule)- at $20 per hour, with $200 deposit balance--Added to Student's TADs account

Other

CONSENT1

I understand that my child must be picked-up by 5:30pm or an additional fee may be applied

I agree

I disagree

CONSENT2

I understand that my child must display positive behavior during and after school or this privilege may be revoked.

I agree

I disagree

CONSENT3

I authorize the admin at UAP to add the cost to my child's TADs account

I agree

I disagree

Submit

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