Park Forest Elementary Enrichment Program 2025
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Name of Student *
Grade *
Emergency Contact Number (please provide at least 2 phone numbers) *
List authorized adults (18 years or older) to sign out your child
I would like to enroll my child in : (Choose one) *
Required
List your child's allergies
List any medications taken in the last year, any illnesses or diseases, or other pertinent medical information:
Are there any problems that may confront your child while attending this program? (fears, anxiety, moodiness, etc.)
I understand that I am responsible to pay for my child's weekly fees and failure to pay on time (before Monday  of the week) will result to non-acceptance in the program. *
Required
I understand that in order for my child to keep the spot in the program, I have to pay each week even my child is absent in school. *
I understand that my child will follow  school rules all the time. Failure to follow will result to dismissal in the program. (1st offense - warning, 2nd offense - talk to the parents, 3rd offense - dismissal in the program). *
To ensure the safety of the students, student's drop-off time is 6:30 AM (No students are allowed before the drop-off time) and pick-up time is NOT later than 5:30 PM. Any late pick-up after 5:30PM is a dollar per minute. *
NO students will be dropped-off in Enrichment Program  if NOT paid or NOT enrolled. Any students dropped -off without payment or NOT enrolled will be reported to child protection program. *
I hereby grant permission for my child to participate in the Park Forest Elementary School Enrichment Program. I have read the handbook and understand the policies and procedures in the handbook.
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Parent/ Guardian who completed this form.
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