After School Program Enrollment Form

After School & Summer Camp Enrollment Form

WELCOME TO TECH GENERATION LEARNING CENTER
Tech Generation Learning Center and STEM & ARTS Academy is pleased to offer high-quality After School and Summer Programs for parents that need care for their children beyond the normal school day. We are open for Afterschool from 2:00 P.M. - 6:00 P.M., Monday -Friday. Our vans and shuttle service will pick children up from their schools daily and bring them to the center for the Afterschool program. Parents are required to pick their child(ren) up from the center prior to 6:00 P.M. We serve children ages 5 -12 years old.

Please complete and submit one form per student being enrolled in the After School or Summer Program.
Enrolling Parent's Name*

First NameLast Name
Enrolling Parent's Cell Phone Number*

Area CodePhone Number
Enrolling Parent's Email*
Child's Name*

First NameLast Name
Current Grade*

KindergartenGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6Grade 7
Please check the After School or Summer Program enrollment option desired for your child:*

3 days per week ( A minimum of 3 days per week is required for enrollment)4 days per week5 days per week
Indicate the day(s) that you anticipate utilizing the After School or Summer Program:*

MondayTuesdayWednesdayThursdayFriday
Please indicate your child's default dismissal plan:
My child will ride the Tech Generation Learning Center Vans / Shuttle from his or her school to the Center on these days (select).

MondayTuesdayWednesdayThursdayFriday
Please note any known allergies or learning disabilities that staff need to be aware of:
Please specify each person, including the name of parents, who has permission to pick up your child from the After School Program.
Authorized Person 1:

First NameLast Name
Phone Number 1:

Area CodePhone Number
Authorized Person 2:

First NameLast Name
Phone Number 2:

Area CodePhone Number
Authorized Person 3:

First NameLast Name
Phone Number 3:

Area CodePhone Number
Statement of Fees

Tech Generation Learning Center accepts childcare certificates for qualified children. Parents paying a cash fee is $65 per week for the Afterschool Program and $75 per week for the Summer Camp Program.
Statement of Policy
- The After School Program ends promptly at 6:00 p.m. After 6:00 p.m., a late charge will be assessed at the rate of $10.00 for each 10 minute interval or fraction thereof that parents/guardians are late picking up their child(ren) from the Center.
- Only persons authorized by the parent or guardian may pick up your child from the After School program. Please notify the Director in writing if anyone other than a parent/guardian will pick up your child. All students attending the After School and Summer Camp Program are required to follow all school and program rules. Behavioral problems will result in parent notification and possible suspension from the program.
- Children demonstrating recurring behavior issues are subject to dismissal from our programs.
I have read and understand the Statement of Fees and Statement of Policy contained here.*

Agree
Should be Empty:

After School & Summer Camp Enrollment Form

Statement of Fees

Statement of Policy