After School Program Enrollment Form

After School Program Enrollment Form

2024-2025
Franklin Community Church is pleased to offer our After School Program for those families that need care for their children beyond the normal school day.

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

First NameLast Name
Parent's Phone Number*

Area CodePhone Number
Parent's Email*
Student's Name*

First NameLast Name
Grade in fall (2024-2025)*

Pre-KKindergartenGrade 1Grade 2Grade 3Grade 4Grade 5
Effective date for enrollment in After School Program*

MonthDayYear
Please indicate the month and day that this agreement is to take effect. For example, if you will be using the After School Program from the first day available , enter 08-19-2024.
Please check the After School Program enrollment option desired for your child:*

1 day per week ($10)2 days per week ($20)3 days per week ($30)4 days per week ($40)5 days per week ($50)
Indicate the day(s) that you anticipate utilizing the After School Program:*

MondayTuesdayWednesdayThursdayFriday
Will Ride the Bus to FCC
Please note any known allergies:
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
Authorized Person 4:

First NameLast Name
Phone Number 4:

Area CodePhone Number
Statement of Fees

$10 Per Day Must pay for the week on Mondays.
Statement of Policy
- An Enrollment Form is required for all students participating in this program.
- Contracts will be billed every Monday of each week.
- The After School Program ends promptly at 5:30 p.m. After 5:30 p.m., a late charge will be assessed at the rate of $10.00 for each 10 minute interval or fraction thereof.
- Wednesday Nights they may stay for church but most be picked up by 7:15pm.
- If a student’s use of the program exceeds the number of days of his/her contract, the hourly rate will apply for the additional hours.
- Students may participate on a drop-in basis with prior notification from parents. If no Enrollment Form has been previously submitted, you will be sent an email with the link to this form to complete and submit.
- 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 Program are required to follow all school and program rules. Behavioral problems will result in parent notification and possible suspension from the program.
- Students with a fever or contagious illness may not participate in the program.
- This program is available for all currently enrolled FS students, grades PreK - 5th Grade.
- Fall semester After School Program runs from August 19, 2024 – December 20, 2024.
- Spring semester After School Program runs from January 6, 2025 – May 22, 2025.
I have read and understand the Statement of Fees and Statement of Policy contained here.*

Agree
Should be Empty:

After School Program Enrollment Form

Statement of Fees

Statement of Policy