After School Program Enrollment Form

After-school Children's Enrichment (ACE) Academy Enrollment Form

2022-2023
The After-school Children's Enrichment Academy, (ACE) is pleased to offer our unique program for those families that need care for their children beyond the normal school day and want an academic use of their children's time. Please complete and submit one form per student being enrolled in the After School Program. Contract rates offer substantial savings compared to the drop in rate. Early dismissal days, Parent-Teacher Conference Days, and Teacher workdays are included in the contract rates. Drop-in rates will be charged at a rate of $45 per day.
Parent Information
Parent's Name*

First NameLast Name
Parent's Phone Number*

Area CodePhone Number
Parent's Email*
Student Information
Student's Name*

First NameLast Name
Grade in fall (2022-2023)*

Grade 2Grade 3Grade 4Grade 5
Please check the ACE Academy Program enrollment option desired for your child:*

5 days per weekDrop-in rate of $45 per day
Indicate the day(s) that you anticipate dropping in and utilizing the ACE Academy Program:*

MondayTuesdayWednesdayThursdayFriday
Please indicate your child's default dismissal plan:
My child will remain in the After School Program until being picked up on:

MondayTuesdayWednesdayThursdayFriday
My child will take the ACE Activity Bus from school on:

MondayTuesdayWednesdayThursdayFriday
Please note any known allergies and any health concerns for your child.
Pick Up Authorization

Please specify each person, including the name of parents, who has permission to pick up your child from the ACE Academy Program.
Authorized Person 1:

First NameLast Name
Person 1 Relation to Child
Phone Number 1:

Area CodePhone Number
Authorized Person 2:

First NameLast Name
Person 2 Relation to Child
Phone Number 2:

Area CodePhone Number
Authorized Person 3:

First NameLast Name
Person 3 Relation to Child
Phone Number 3:

Area CodePhone Number
Statement of Fees

The registration fee is $75 for the first child. Additional sibling registrations will be $25 each. The weekly contract cost for the ACE Academy is $125. This price includes transportation to the ACE Academy and the program. The cost is $110 without transportation.
Payment Information
Statement of Policy
- An Enrollment Form is required for all students participating in this program.
- The ACE Academy program requires a two-week notice of cancellation cancellation
- The ACE Academy program ends promptly at 6:30 p.m. After 6:30 p.m., a late charge will be assessed at the rate of $10.00 for each 10-minute interval or fraction thereof.
- Families may take a 5-day vacation without financial penalty, with advance notice to staff.
- Students may participate on a drop-in basis with prior notification from parents. If no Enrollment Form has been previously submitted, you will be sent an email with the link to this form to complete and submit.
  Students may only drop-in twice a week.
- Only persons authorized by the parent or guardian may pick up your child from the After School program. Please notify the Director in writing at director@aceacademy-fcbc.org if anyone other than a parent/guardian will pick up your child. You must also call the director at (757)358-8641 and leave a message.
- All students attending the After School Program are required to follow all school and program rules. Behavioral problems will result in parent notification and possible suspension from the program.
- Students with a fever or contagious illness may not participate in the program.
- Spring semester After School Program runs from the present 2023 – June 12, 2023.
Signature

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I have read and understand the Statement of Fees and Statement of Policy contained here.*

Agree
I give the ACE Academy permission to take my student's picture for educational purposes or advertisement for the ACE Academy.*

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After-school Children's Enrichment (ACE) Academy Enrollment Form

Parent Information

Student Information

Pick Up Authorization

Statement of Fees

Payment Information

Statement of Policy