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
Warrior Jumpstart and VPK Extended Day / Aftercare
Categories:
All
All
prev
next
( X )
Extended Day - Single Day
$15.00
$
15.00
Quantity
1
2
Extended Day - Two Days
$30.00
$
30.00
Quantity
1
2
Extended Day - Three Days
$45.00
$
45.00
Quantity
1
2
Extended Day - Monday-Thursday
$55.00
$
55.00
Quantity
1
2
Aftercare - Single Day
$15.00
$
15.00
Quantity
1
2
Aftercare - Two Days
$30.00
$
30.00
Quantity
1
2
Aftercare - Three Days
$45.00
$
45.00
Quantity
1
2
Aftercare - Monday- Thursday
$55.00
$
55.00
Quantity
1
2
Parent Partner Fee
Please specify what month you are paying for in the notes.
$50.00
$
50.00
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
Should be Empty: