After Care Day Registration Form

After Care Registration
Please register for extended day by filling out this form. Payment will be through Blackbaud Tuition Manager.

After care is only held when school is in session. There is no aftercare during half days. After care will take place in the library, room 222, or the playground. Please come into the building to check out your child.
Student Information
Student's Name*

First NameLast Name
Grade*
Extended Day Selection- Semester 1*
Extended Day Selection- Semester 2*
If you select that you won't need after care, you can always contact us to update that choice.
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 Blackbaud Tuition to pay for after care.*

Yes
Signature*

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After Care Registration