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.
*Changes and Re-entry to the program will go into effect the following Monday, if the change is received Monday - Thursday (Thursday by 3pm) of the preceding week. Changes received after 3pm on Thursday, will go into effect one week from the following Monday.
*Withdrawals made on or before the 25th of the month will go into effect the next month.
*Months are not prorated.
First and Last Name of Child (one form per child)
School Child Attends
Parent's Name filling out the form and phone number
Is the change in reference to Before Care, After Care or Both
Both Before Care and After Care
Are you cancelling Before and/or After Care? Cancellations go into effect on the last day of the month and must be received by the 25th of the month, otherwise the change will be reflected on the following month.
Yes, cancelling Before Care for all days signed up for
Yes, cancelling After Care for all days signed up for
Yes, cancelling Before and After Care for all days signed up for
Changes to Before Care registration: please select the days you would like your child to attend Before Care going forward.
Before Care Monday
Before Care Tuesday
Before Care Wednesday
Before Care Thursday
Before Care Friday
Changes to After Care registration: please select the days you would like your child to attend After Care going forward.
After Care Monday
After Care Tuesday
After Care Wednesday
After Care Thursday
After Care Friday
If you are making a change to After Care Pick up time, which time slot will you be signing up for?
Pick up by 4:30 pm
Pick up by 6:30 pm
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This form was created inside of Glen Rock Public Schools.
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