RALEIGH OAK CHARTER SCHOOL BEFORE/AFTER CARE REGISTRATION

Raleigh Oak Charter School will provide a before care program from 7:00am-8:30am Monday-Friday and an after care program from 3:30pm-6:00pm Monday-Friday. Part time and drop in options will be available.The BAC program will follow the Raleigh Oak Charter School Calendar. 

*Care will not be provided on early release, holidays, vacation & teacher work days.*


Email *
Child's Name: *
Date of Birth: *
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Child's Physical Address: *
BEFORE CARE (7:00am-8:30am)  Please indicate your requested before care schedule: *
Required
If you selected part time, please indicate below which days you need BEFORE CARE for your child:
AFTER CARE (3:30pm-6:00pm))  Please indicate your requested after care schedule: *
Required
If you selected part time, please indicate below which days you need AFTER CARE for your child:
Mother/Guardian Name: *
Phone Number: *
Father/Guardian Name: *
Phone Number: *
Your child will be released to the parents/guardians listed above. Please list the name(s) and phone number(s) of any other people authorized to pick up your child:
In the event of an emergency, if the parents/guardians cannot be reached, the facility has permission to contact the following individuals. Please list emergency contact name(s) and phone number(s):
 *
Please list any health care needs or concerns (including allergies), symptoms of and any type of response for these health care needs or concerns:
Please share any other information about your child that you feel is important for the staff of Raleigh Oak Charter School BAC to know in order to ensure a positive experience for your child:
EMERGENCY MEDICAL CARE INFORMATION & AUTHORIZATION:
Please list the name, address and phone number of your child's Pediatrician:
 *
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