After School Program
Please complete this registration packet to enroll your child in the After School Program. You can sign up one or two children per form response. If you have three or more children to register, please use a second form. Schedule requests will be confirmed directly by the ASP Director.

Current registration is for August through December. A second round of registration will be sent out over Winter Break for January through June.

- The participation fee is $16/day or $80 for the week. Payments must be paid in advance, prior to the start of each new month.
- We have a 7-day notification policy for adding or dropping days, and payments must be made in advance. This allows for appropriate staffing.
- Credit for unused days due to illness, or days dropped at least 7 days in advance will be reflected in the following month’s invoice. The credit must be used within that month. There are no cash refunds for unused days.
- There is a late fee of $1.00 per minute after 5:00 PM.
- Our program will be a licensed child care program and families will be able to apply for a subsidy. We will be happy to assist with the application process.

The information we are requesting is required under State of Vermont licensing rules. We apologize for the length of this form. Before beginning, be sure to have the following information ready:
1. Parent and guardians address, phone numbers
2. Medical information including name and phone number of doctor, date of last physical, date of last tetanus booster, and names of any medications currently taken.
3. Insurance information including policy number, company phone number.
4. Names and cell phone numbers of any person you will allow to pick up your child from the program.

If you do not know the answer to a required question, you can type in N/A in order to continue. Applications are not complete until all of the required information is received.
Email address *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy