After School Care Registration Form

Parent(s) Name(s)*

Email Address*

Contact Number*

Do you recieve Text at this number?*

YesNo

Address*

City*

Student's Name*

Student's grade level*

Zip Code*

Student's Gender*

MaleFemale

Student's Date of Birth (mm/dd/yyyy)*

School Enrolled for ‘25-‘26 school year*

There is a $150 Registration/Supply fee,

due with the Application.

This can be paid in person, or by invoice.

First week's tuition and a deposit is also due at the time of registration.

The deposit is equal to one monthly payment or one

weekly payment $140 depending on your invoice type.

**Tuition is due on or before the first of each month.

If payment is not received by the 1st of each month,

an additional fee of 5% will be assessed.

**For weekly payment plan, payment is due by 9am each Monday; If payment is not received by 9am, a late fee of $10 will be applied each day until payment is made. Your child will not be permitted into camp without payment.

Please Select your Preferred Session*

Weekly Price ($150/week)Daily Price ($40/day)Monthly Price ($600) Note: Payments are due weekly or monthly bi-weekly is also available let us know what you prefer.Ask about our scholarship options if needing financial assistance!

We occasionally take pictures of the kids in action with the materials or doing other activities for our website and/or blog. We hope to use these to keep parents up to date on the happenings at school.

Please click yes if you WILL give permission to have photographs of your child taken*

YesNoOnly for my personal update/emails etc.

How did you find us?*

If you were referred by a friend please let us know who, so we can thank them!

Club Add-ons (General Homework Help is included in Care cost)

Transportation (from school to Kidz Club)Boxing Program (based on interest)Tutoring

Tuition Preference

VenmoSquare Invoice (Sent to email on file) Note:3% surcharge will be appliedCashCheck