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ASCS Before School Care 2024-2025
Please fill out one registration form PER child. Any questions, please contact
office@ascs.net
or Ms. Goodwin in main office.
Click here for the program fees and guidelines
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* Indicates required question
Date
*
MM
/
DD
/
YYYY
Child Name
*
Your answer
Child Grade:
*
Choose
PK 3
PK 4
Kindergarten
1
2
3
4
5
6
7
8
Child DOB
*
MM
/
DD
/
YYYY
What days will your child attend?
*
Monday
Tuesday
Wednesday
Thursday
Friday
Required
Parent or Guardian Name
*
Your answer
Parent or Guardian Email
*
Your answer
Parent or Guardian Cell Number
*
Your answer
Parent or Guardian Employer
Your answer
Parent or Guardian Work Tel.
Your answer
Parent 2 Name
Your answer
Parent 2 Cell
Your answer
Parent 2 Employer
Your answer
Parent 2 Work Tel.
Your answer
Name of Emergency Contact (if neither parent can be reached)
*
Your answer
Emergency Contact Relationship
Your answer
Emergency Contact Phone Number
*
Your answer
Other than the names above, who may pick up your child?
*
Your answer
Please list any allergies, chronic conditions, health problems
Your answer
I have read Extended Day Program Guidelines.
*
Yes
Required
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