Hort Sign-Up

Student Name

Last NameFirst Name

Grade

Guardian Name

Last NameFirst Name

Guardian E-Mail

I am requesting the following after school care starting as of:

Please choose the date when you wish to start Hort (Starting August 18, 2016))

MonthDayYear

Please choose one:

Please select:

Rows	Monday	Tuesday	Wednesday	Thursday	Friday
From 2:00 pm
From 3:00 pm
To 3:00 pm
To 4:00 pm
To 5:00 pm
To 6:00 pm

By submitting this enrollment application for the Hort & After School Care Program, I hereby certify that I agree to the rules and terms of our Hort & After School Care Program.

Billing will be by the 10th of the month for the previous month. Payment is due by the 15th, after that a late fee of $25 will be assessed.

Late pick-ups (after 6pm) will be charged a fee of $20 for the first 15 minutes plus $1 for each additional minute.

E-mail

I accept

German-American International School, 275 Elliott Drive, Menlo Park, CA, 94025
+1 (650) 324 8617 www.gais.org info@gais.org