Warrior Online Payment Form
Student Name
*
First Name
Last Name
Parent/Guardian Name
*
First Name
Last Name
Email
*
example@example.com
Date/Week of care
*
Please add in the date or week you are paying for.
Invoice Number
Notes
VPK Extended Day / Aftercare
prev
next
( X )
VPK Extended Day - Single Day
$
15.00
VPK Extended Day - Two Days
$
30.00
VPK Extended Day - Three Days
$
45.00
VPK Extended Day - Monday-Thursday
$
55.00
Aftercare - Single Day
$
15.00
Aftercare - Two Days
$
30.00
Aftercare - Three Days
$
45.00
Aftercare - Monday- Thursday
$
55.00
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
Signature
*
Submit
Payment Confirmation
Not Confirmed
Confirmed
Should be Empty: