Ruth Harman Academy Extended Care Registration Form 2024-2025
Dear Ruth Harman Family,

We are so excited for our first year!

If you haven't done so already please go to the KUSD or Ruth website and fill out the annual registration for the Kenosha Unified School District.
https://www.kusd.edu/registration/

Please provide the following information for each student attending the Ruth Harman Extended care program.

PLEASE NOTE: $25.00 registration fee must be paid prior to using the extended care program. Payments can be made through The Ruth Harman Academy School Store: https://kenoshaunifiedwi.infinitecampus.org/campus/store/kenosha_unified/school-store/1/categories

A copy of this form can be found online at the Ruth Harman Academy website if needed, for refernece. 
Email *
Student First Name: *
Student Last Name: *
Student Grade *
Student First Name:
Student Last Name:
Student Grade
Student First Name:
Student Last Name:
Student Grade
Student First Name:
Student Last Name:
Student Grade
Student First Name:
Student Last Name:
Student Grade
Parent/Guardian 1: *
Phone: *
Email: *
Address: *
Parent Guardian 2:
Phone:
Email:

Address:
Student(s) Live With: *
1. Are your children allowed to have a snack at a $1.00 charge? *
Additional Snacks? *
2. Are your children allowed to have a drink at a $1.00 charge? *
Additional drinks? *
3. Would you like your children to start their homework in aftercare? *
4. Are your children allowed to go on their Chromebook during aftercare? *
5. If your child is allowed to use their Chromebook, are they allowed to play video games or go on the Internet? *
6. Does your child have any food allergies or allergies that we should know about? If so, please list completely: *
7. Does your child have any health concerns that we should know about? (Asthma, heart conditions, etc.) Does this condition limit them in any way? *
8. If there is anything special that you would like us to know about your child/ children, please detail here:
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