21-22 Bus After School Registration

Zion Lutheran After School Care Bus Program

2021-2022 School Year Registration

Please complete this from and submit it to the ECC Office to secure a space for your child in our 2021-2022 program. The registration fee is $40.
Child's Name
Sex

M F
Date of Birth

Month Day Year
Date
Mom's Name
Cell Phone
Dad's Name
Cell Phone
Emergency Phone #
Please enter a valid phone number.
Address
City
State
Zip Code
Email
example@example.com
Please list all Allergies
Public School Attending
Grade
Fees: After School Care = $45 per week
Non-School Extended Care = $45 per day

Sign the Payment Policy agreement on the next page:
ZION LUTHERAN CHURCH
Hope and Growth Through The Light of Jesus Christ

Zion Lutheran Early Childhood Center

Bus After School Care Payment Policy

Bus After School Care bills are Normally produced on the first and third Mondays of the month. Fees are payable for all scheduled days, even if some days are missed due to illness, holiday, vacation, or other reasons. A student's failure to attend does not reduce charged fees. Payment of each two-week bill is expected to be paid by the Friday of the first week. Failure to pay fees on time, and in full, could jeopardize a child's

The following holidays are considered regular school days and you will be billed for them: Labor Day, Veterans Day, Thanksgiving Day and the Break, Martin Luther King, Jr. Day, Presidents Day, Good Friday, Easter Monday, and Memorial Day.
Parent/Guardian eSignature (Please type full name)
Date

Month Day Year
Date
Should be Empty:

ZION LUTHERAN CHURCH