Before & After Care 2019
Please complete a separate form for each child enrolled.
Student Last Name *
Your answer
Student First Name *
Your answer
Parent or guardian name(s) *
Your answer
Home address *
Your answer
Email address *
Your answer
Daytime number #1 *
Your answer
Daytime number #2
Your answer
List of persons to call in an Emergency or Release Child to (if parent/guardian cannot be reached): *
Include telephone number for emergency contacts
Your answer
Additional Information
Special needs, allergies, likes, dislikes, things to look for
Your answer
What program(s) will your child be attending and need Before/After care? *
Please choose all that apply.
Required
Weekly Attendance Schedule BEFORE care
Please provide approximate day(s) of the week your child will most likely be dropped off at the BEFORE care program.
Weekly Attendance Schedule AFTER care
Please provide approximate day(s) of the week your child will most likely be attending the AFTER care program.
Before & After Care parent acknowledgment form *
Required
Photo Permission Form *
I acknowledge that I have read the information above and agree to adhere to the guidelines and procedure set by the Farmington Public Schools. I have completed the emergency contact list and enrollment form to the best of my knowledge so that it is current and accurate. *
Your name will serve as a digital signature
Your answer
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