Thorp After Care (Tuition Based After School Program)
Please fill out this form to reserve your spot for our after care program.
The program will begin the first day of school and run throughout the duration of the school year, Monday through Friday from 2:45 until 6:00 pm (Snack will be provided). Students must be picked up by 6:00 pm a $25.00 Late Fee will be charged.
Monthly payments are due on the 16th of each month (a Late Fee will be charged if not received by the 16th).
Parents: We understand throughout the year students will participate in extra-curricular activities (ie Sports, Theater, Out of School Time). We ask you notify us via email.
* Required
Email address
*
Your email
Program Selection
*
5 Day a Week Program
3 Day a Week Program
Drop In
Other:
Required
Please select the days your child will be staying after school. (Select all days if you are enrolled in the five day program.)
Monday
Tuesday
Wednesday
Thursday
Friday
Student First Name
*
Your answer
Student Last Name
*
Your answer
Student Grade Level
*
Choose
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
Parent Name (Contact #1)
*
Your answer
Primary Phone # (Contact #1)
*
Your answer
Alt Phone # (Contact #1)
*
Your answer
Parent Name (Contact #2)
*
Your answer
Primary Phone # (Contact #2)
*
Your answer
Alt Phone # (Contact #2)
*
Your answer
Parent (Contact #2) Email Address
*
Your answer
Does student have any other sibling(s) at Thorp?
*
Yes
No
Required
Sibling at Thorp
Your answer
Sibling at Thorp
Your answer
Sibling at Thorp
Your answer
Does your student have a 504/IEP?
*
Yes
No
Does student have any medical conditions/allergies?
*
Your answer
Does student have any restrictions/limitations?
*
Your answer
In the event of Emergency Please Contact:
*
Your answer
Emergency Contact Phone #:
*
Your answer
Is there a court order of protection against any individual?
*
Yes
No
Required
Any Comments or Questions you may have?
*
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Chicago Public Schools.
Report Abuse
Forms
