After Care Day Registration Form

After Care Registration
Please register for extended day by filling out this form. Payment will be through FACTS Tuition Manager, and be billed as a monthly charge.

After care is only held when school is in session. There is no aftercare during half days.

Semester 1: August 18th - December 17th (79 days)

Semester 2: January 6th - May 21st (89 days)
Student Information
Student's Name*

First NameLast Name
Grade*
Extended Day Selection- Semester 1*
Aug. 18th - Dec. 17th (79 days)
Extended Day Selection- Semester 2*
Jan. 6th - May 21st (89 days)
Parent/Guardian Information
Name*

First NameLast Name
Cell Number*
E-mail*
example@example.com
Emergency Information
Emergency Contact's Name*

First NameLast Name
Phone Number*
Does the student have any allergies, chronic illness, or medical conditions? If yes, please describe.*
If no, type N/A or no.
Date*

MonthDayYear
Date
I understand I need to go to FACTS Tuition Manager to pay for after care.*

Yes
Signature*

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After Care Registration