Drop in Day Registration
Drop-in days include before and/or after care when school is in session, but school year enrollment is not required. Submit this form with payment at least two (2) weeks prior to the requested drop-in days for the 2019-2020 school year.

You must create an account at www.webstercentral.revtrak.net before registering and add a payment method (credit card or echeck). This payment method will be used to charge the fee for all drop-in days ($25 per day for PM Care and $10 per day for AM Care, regardless of drop off and pick up times). A one time non-refundable registration fee must be on file in order to reserve requested days.

Drop-in care will only be offered if space is available. The child will be required to attend the drop-in program at his or her school building, unless otherwise indicated.

Student Name(s) *
Your answer
Student School *
Parent/guardian #1 and Cell phone number *
Your answer
Parent/guardian #1 email *
Your answer
Parent/guardian #2 and Cell phone number
Your answer
Parent/guardian #2 email
Your answer
List the dates requested for drop-in care and indicate AM, PM, or BOTH: *
Your answer
Please list any allergies of student(s):
Your answer
Please list emergency contact(s) *these names will also be authorized for pick up - please include phone number *
Your answer
Medical Consent: In case of an accident or injury in which I - or person(s) designated above - cannot be reached, I agree that emergency medical care, dental treatment, and/or emergency transportation may be given. I agree to pay for all medical expenses incurred on my child’s behalf. *Typing your name constitutes a legal signature confirming that I acknowledge and agree to the above Medical Consent. *
Your answer
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