Before/Aftercare Registration
2017-2018

To register, please fill out this contract form (one for each child) and submit it with the $25.00 registration fee to the SCPS Business office or through your Student Billing Account in ParentsWeb by August 9, 2017. Doing so will secure a space for your child in the Before & After School Care Program (as detailed below). The fees listed below will be billed over a nine month period beginning in August and ending in April. A May 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.

Type of Care Needed:
Student's First and Last Name:
Your answer
Grade Entering:
Gender
Age:
Your answer
Date of Birth:
MM
/
DD
/
YYYY
Mother's Name:
Your answer
Mother's Cell Phone Number:
Your answer
Mother's Email Address:
Your answer
Father's Name:
Your answer
Father's Cell Phone Number:
Your answer
Father'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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