CDS Extended Day Program
Please complete the form below for each child whom you would like to enroll in our Extended Day Program. If you have any questions, contact Jordan Hoover at
Parent Contact E-mail *
Your answer
Parent Cell Phone *
Your answer
Student First Name *
Your answer
Student Last Name *
Your answer
Grade *
Please list any allergies or medical concerns the Extended Day staff should know.
Your answer
Please check one. *
If you checked 'Daily' above, if possible for our planning purposes, please indicate which days you would like to sign up for on a recurring basis.
Full Day (pick-up until 6 p.m. Monday to Thursday and until 5 p.m. Friday); Partial Day - (pick-up until 5 p.m. Monday to Thursday and until 4 p.m. Friday)
Full Day
Partial Day
Additional comments or information about your Extended Day request:
(e.g., start and stop dates of Extended Day needs)
Your answer
Never submit passwords through Google Forms.
This form was created inside of Community Day School. Report Abuse - Terms of Service