SCPS Lower School Before/Aftercare Registration
2018-2019

To register, please fill out this contract form (one for each child) and submit it by August 14, 2018. Doing so will secure a space for your child in the Before & Aftercare Program (as detailed below). Once the form is completed, a one time $25 registration fee will be charged to your FACTS account.

For those that register after August 14, a one time registration fee of $35 will be charged to your FACTS account. Registering your child(ren) by August 14 ensures we have the correct teacher/student ratio.

The fees listed below will be billed over a nine month period beginning in September and ending in May. An August payment is NOT required. THIS IS A PAYMENT SCHEDULE for the programs that cover the entire 36 weeks of school (180 days).

There are NO adjustments for Christmas break, Spring break, school holidays, etc. You will be notified if care will be provided during the breaks and school holidays. An additional daily fee is required for extra days of care; lunch is provided on those days.

Your obligation is month to month and requires a 2 week notice to discontinue participation. A drop-in fee of $40.00 will be charged for daily drop-ins.
**We do not send monthly statements.

Email address *
Type of Care Needed: *
Student First Name/Name Student Goes By: *
Your answer
Student Last Name: *
Your answer
Grade Entering: *
Gender *
Age: *
Your answer
Date of Birth: *
MM
/
DD
/
YYYY
Primary Contact Name & Relationship to Student: *
Your answer
Primary Contact's Cell Phone Number: *
Your answer
Primary Contact's Email Address: *
Your answer
Secondary Contact Name & Relationship to Student: *
Your answer
Secondary Contact's Cell Phone Number: *
Your answer
Secondary Contact's Email Address: *
Your answer
Emergency Contact Name: *
Your answer
Emergency Contact Phone Number: *
Your answer
Pediatrician: *
Your answer
Preferred Hospital: *
Your answer
Health Insurance: *
Your answer
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