Extended Day Program Registration
Available all school days from 7:00-8:05 am and 2:35-6:00 pm. Cost is $5.50 per hour per child.
Student Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Age *
Your answer
Gender *
Allergies *
Your answer
I will utilize EDP on an "As Needed" Basis Only *
Drop-Off Time (7:00-8:00 AM)
Time
:
Pick-Up Time (2:35-6:00 PM)
Time
:
Mother/Guardian Information (Name & Phone) *
Your answer
Father/Guardian Information (Name & Phone) *
Your answer
All Other Adults Approved to Pick-Up (Name & Phone) *
Your answer
Please type your electronic signature below indicating that you have received a copy of the NCCS Parent-Student Handbook and understand that all school policies and rules apply to EDP. I further agree to comply with these policies. *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of North Clackamas Christian School. Report Abuse - Terms of Service