• After School Program Enrollment Form

    2021-2022
  • Grace Resource Development Center is pleased to offer our After School Program for those families that need care for their children beyond the normal school day. We offer  child care for Early Dismissal Days, Parent/Teacher Conference Days, and Faculty Workdays. Our Rates are $70 a week or $15 a day. Please complete and submit one form per student being enrolled in the After School Program and enclose the $35 application fee.

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  • Student Information

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    Pick a Date
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    Pick a Date
  • Please specify each person, including the name of parents, who has permission to pick up your child from the After School Program.
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  • Informed Consent and Acknowledgement

    I hereby give my approval for my child's participation in any and all activities prepared by Grace Resource After School Program. In exchange for the acceptance of said child's candidacy by Grace Resource Development Center. I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Grace Resource Development Center and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to participating in, or returning from selection sessions. In case of injury to said child, I hereby waive all claims against Grace Resource Development Center, including all program coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including dance and some outdoor activities. Some of these injuries include, but are not limited to, the risk of fractures, or death.
  • Medical Release and Authorization

    As Parent and/or Guardian of the name child, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor's life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed. Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named child. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me. Permission is also granted to the Grace Resource Development Center and its affiliates including Directors, Teachers and Staff to provide the needed emergency treatment prior to the child's admission to the medical facility. Release authorized on the dates and/or duration of the registered season. This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.
  • An Enrollment Form is required for all students participating in this program.  Payments are due EVERY MONDAY BEFORE CHILD ENTERS THE PROGRAM. Late fees will be billed daily. The After School Program ends promptly at 7:00 p.m. After 7:00 p.m., a late fee will be assessed at $5 for the first 5 minutes and $2 a minute after that. Delinquent accounts may result in dismissal of student from the After School Program.  

  • All payments can be made through cash, money order or through cashapp: $gracecovenant1 or through paypal: Paypal.me/gracecovenant

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