2019 HCCS STARTALK Before and After Care Program
Hope Chinese Charter School & Tiny Dragons offer the option of a fee based before and after care program for those accepted into the 2019 HCCS STARTALK STEAM-Integrated Chinese Summer program.

Registration is based upon space availability. Please fill out one form for each student.

Weekly Rate:
Before care: 7:45 AM - 8:45 AM, M-F: $40 per week
After care: 3:30 PM - 5:30 PM, M-F: $80 per week

Drop-in Rate:
Before Care drop-in: $10 per day
After Care drop-in: $20 per day

Student Information
Student's Last Name *
Your answer
Student's First Name *
Your answer
Allergies *
Your answer
Address *
Your answer
Sign my student up for:
Before Care: $40/week *
Required
Total Before Care: *
Your answer
After Care: $80/week *
Required
Total After Care: *
Your answer
Total Payment (Before+After Care) Due: *
Your answer
Payment due at the time of registration via: *
Parent/ Guardian Information
Parent/ Guardian #1 Full Name *
Your answer
Parent/Guardian #1 Email Address *
Your answer
Parent/Guardian #1 Phone Number *
Your answer
Parent/ Guardian #2 Full Name *
Your answer
Parent/Guardian #2 Email Address *
Your answer
Parent/Guardian #2 Phone Number *
Your answer
Emergency Contact (other than parent or primary caregiver) - Full Name: *
Your answer
Relation to student: *
Your answer
Phone Number: *
Your answer
Other Terms & Conditions
I understand and agree to the following terms as indicated by checking the box next to each statement below:
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Thank You.
Hope Chinese Charter School does not unlawfully discriminate on the basis of race, color, creed, religion, national origin, gender, status with regard to public assistance, disability, sexual orientation, age nor any other protected class. HCCS also makes reasonable accommodations for students with disabilities, special needs and limited English proficiency.
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