PCS Before & Aftercare Registration Form 18-19
Welcome to the 2018-19 school year! We have a lot of exciting programs in store for the PCS Before and After Care Program. Here are some of the highlights of the BAC Program.

****Families with balances not in good standings from previous year will not be allowed to sign up for the 2018-2019 BAC program****

If you have questions regarding this requirement or any outstanding balance, please contact Katie Lydon.

The BAC program is on a first come first serve basis. There are a limited number of spots for the BAC program. Please make sure you turn your child/children’s paperwork in as soon as possible to one of the front offices or Mr. Lydon. Processing of the registration packet can take up to a week. After acceptance into the BAC program please make sure you read over the BAC Handbook and sign the acknowledgment (at the end of the handbook) to complete the registration process.

Please see the BAC handbook for information on the following policies…
• Snow Days / Late Start
• Billing / Payments
• Admittance and Release
• Late Pick Up
• Illness / Injury
• Behavior / Discipline
• Personal Items
• Technology
• Drop Ins

BAC Program Times
• Before School Program: 6:15 a.m. – 8:10 a.m. (Includes breakfast)
• After School Program: 3:25 p.m. – 6:00 p.m. (Includes afterschool snack)
• Early Dismissal Days: Dismissal – 4:00 p.m. (includes afterschool snack) Only available on scheduled early dismissal days (9/21, 10/25, 12/21, 3/21, 4/19, 5/10)
• There will be NO aftercare on the first day of school (Aug. 16th) or last day of school, (May 24th). Please make arrangements ahead of time so your child is picked up by dismissal, 12:00 pm (noon).

We look forward to partnering with you this year to ensure your child’s continuous success at PCS! Thank You!

Josh Lydon
Before and After Care Program Director
P: 314-645-9600 ext: 427
Aftercare Cell: 314-398-7603
F: 314-645-9700 Attn: Josh Lydon or BAC
jlydon@premiercharterschool.org

Parent/Guardian Information
Parent / Guardian 1 Name *
Your answer
Parent / Guardian 1 Email
Your answer
Parent / Guardian 1 Cell Phone Number *
Your answer
Parent / Guardian 1 Work Phone Number
Your answer
Parent / Guardian 2 Name
Your answer
Parent / Guardian 2 Email
Your answer
Parent / Guardian 2 Cell Phone Number
Your answer
Parent / Guardian 2 Work Phone Number
Your answer
Student Information
How many students are you enrolling in the BAC program? *
Your answer
Student 1 Name *
Your answer
Student 1 Grade *
Student 1 (Please list any allergies or conditions that we may need to know about)
Your answer
Student 2 Name
Your answer
Student 2 Grade
Student 2 (Please list any allergies or conditions that we may need to know about)
Your answer
Student 3 Name
Your answer
Student 3 Grade
Student 3 (Please list any allergies or conditions that we may need to know about)
Your answer
Student 4 Name
Your answer
Student 4 Grade
Student 4 (Please list any allergies or conditions that we may need to know about)
Your answer
Additional Student's Names
Your answer
Additional Student's Grades
BAC Program Acknowledgments
Please the boxes agreeing to the following statements *
Required
Please initial (electronically) agreeing that you have read the BAC Handbook, which can be found at... http://images.pcmac.org/SiSFiles/Schools/MO/StLouisCharterSchool/PremierAcademy/Uploads/DocumentsCategories/Documents/BAC_Handbook_%7BSISF6A841AAA53E%7D.pdf *
Your answer
Please select which BAC program(s) your family will need (you may select more than one) *
Required
Please select your payment option *
Required
Important Information about the BAC program
Please see the Billing Chart (on the PCS website) for program pricing
Daily drop in fees: BEFORE CARE: $5.00, AFTER CARE: $15.00, HALF DAYS: $25.00
Each child is ONLY allowed 5 drop ins per program per school year

Please submit the completed application and 1st month’s payment along with any DSS forms and/ or the Free and Reduced State form AS SOON AS POSSIBLE. This is a first come first serve program with limited spots available. Once spots have been filled students will be placed on a waiting list.

IMPORTANT BILLING INFORMATION
• Families with multiple children enrolled will receive a 40% discount for each additional child
• If you have an outstanding balance from the previous school year for Before/After Care services, your account must be in good standings before acceptance into the 2018-2019 program. Contact Katie Lydon for details.
• Financial Assistance: This may ONLY be obtained through the Free & Reduced State program or Division of Social Services subsidy. To apply, an application for Free & Reduced meals needs to be completed. This form may be obtained from the office or on the school website.
• If DSS is providing a subsidy, then the DSS caseworker must provide the appropriate form. PCS DVN number is 002238528. You will be billed for the program you select until PCS has received the approval letter from DSS.
• Families with balances not in good standings from previous years will not be accepted into the 2018-2019 BAC program and will be placed on the waiting list.

Please electronically sign (type your name) agreeing that you will make the necessary payments for the BAC program you choose *
Your answer
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