CUB CARE
MORNING & AFTER SCHOOL CARE REGISTRATION
Morning Care Information
Morning care begins at 6:15 a.m. each school day. Morning care fee is $25 each month. There is no additional fees for siblings. Students may be dropped off for morning care between 6:15 - 6:50 a.m. Students arriving after 6:50 a.m. will be asked to wait for normal morning school drop-off at 7:15.
After School Care Information
After School care begins at 4:00 p.m. and ends at 6 p.m. each school day. There is a monthly fee for after school care with an additional $15 fee additional siblings, or a drop in daily rate of $10 per child.
I am registering my child(ren) for:
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Please Select
Morning Care
After School Care
Morning and After School Care
Wednesday (After School Care Only)
Student Name (Oldest Child)
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First Name
Last Name
Student Name #2
First Name
Last Name
Student Name #3
First Name
Last Name
Student Name #4
First Name
Last Name
Student Name #5
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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PARENT / GUARDIAN INFORMATION
Parent / Guardian #1
*
First Name
Last Name
Parent / Guardian #1 - Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent / Guardian #1 - Email
*
example@example.com
Parent / Guardian #2
First Name
Last Name
Parent / Guardian #2 - Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Parent / Guardian #2 - Email
example@example.com
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EMEGENCY CONTACTS
Please list anyone authorized to pick-up your child from Cub Care. Any person picking up your child must present a valid ID.
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Rows
First & Last Name
Phone Number
Authorized to Pick Up My Child
1.
Yes
No
2.
Yes
No
3.
Yes
No
4.
Yes
No
5.
Yes
No
6.
Yes
No
7.
Yes
No
8.
Yes
No
9.
Yes
No
10.
Yes
No
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ACKNOWLEDGEMENTS & ASSURANCES
I understand there is a $25 deposit fee for After School care. The deposit covers the first week of After School Care only. Initials
*
I understand there is a monthly fee for Cub care, or I have the option to pay for a drop in rate of $10 per child. Drop in payments must be paid the day of service. Initials
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I understand that payments are due on the first school day of each month. You will be allowed a three day grace period for the payment to be submitted from the date it is due. If your payment has not been submitted prior to the three day grace period, your child, will not be allowed to participate in the Cub Care program. Please contact the front office with any payment concerns. Initials
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I understand my child(ran) must be dropped off in morning Cub Care no later than 6:50 a.m. Students arriving after 6:50 a.m. must wait in the regular car line. Initials
*
I understand my child(ran) must be picked up by 6:00 p.m. from After School Care. There is a fee of $1.00 for every minute beyond 6:00p.m. Initials
*
I understand that all payments must be paid in cash to the front office, and I will receive all invoices and receipts by email. Initials
*
I understand my child must abide by all school rules during Cub Care. Initials
*
I understand my child behavior during regular school hours may affect his/her ability to stay in Cub Care. Initials
*
I understand my child must be present at school by 10 a.m. to participate in After School Care.
*
I understand there is no After School Care on Friday, December 20th, and Thursday, May 29th.
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Signature
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
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