Glen Rock Community School Before & After Care Change/Cancel Form
*One form per child must be filled out.
*Changes to Before and After care registration will have a $20 fee applied to your account.
*Entry opportunities into the program are on the 1st and 15th of the month (or date after if the 15th falls on a weekend).
*Withdrawals made on or before the 25th of the month will go into effect the next month.
*Months are not prorated.
Email address *
First and Last Name of Child (one form per child) *
School Child Attends *
Parent's Name filling out the form and phone number *
We would like to cancel all of our days.
Clear selection
We would like to add these Before Care days.
Monday
Tuesday
Wednesday
Thursday
Friday
Before Care
We would like to add these After Care days.
Monday
Tuesday
Wednesday
Thursday
Friday
After Care
We would like to delete these Before Care days.
Monday
Tuesday
Wednesday
Thursday
Friday
Before Care
We would like to delete these After Care days.
Monday
Tuesday
Wednesday
Thursday
Friday
After Care
Date these changes should go into effect. Entry opportunities into the program are on the 1st and 15th of the month (or date after if the 15th falls on a weekend).
MM
/
DD
/
YYYY
Submit
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