Personal Time Request Form

EARLY CHILDHOOD Extended Care Drop-in Request Form

NOTE: You may NOT assume that your student can stay for Extended Care UNTIL you receive an Approval Email.
**Sign-ups should be requested at least 24 hours in advance**

Same Day Drop-ins Requests are discouraged and may be denied due to the program being full.

You may NOT assume that your student can stay for Extended Care UNTIL you receive an Approval Email.

Please complete a separate form for each student for any Drop-In Extended Care needs.

Drop-In Rate is $8.25 for every 30 minutes.

EC students will need a packed lunch!

EC Students will be picked up outside the Rose Building on the EC side.

Please also be mindful of arriving no later than 5:30pm to avoid Late Pick-up Fees which are $1 per minute which will be charged via Homeroom.

Claudine Collet is our Extended Care Coordinator. Please contact her with any questions at ccollet@waldorfct.org.
Your Name*

First NameLast Name
Your Email*
example@example.com
Child's First Name*
Child's Last Name*
EC Class*
Please select date of drop-in*

MonthDayYear
Date
Please select Extended Care option:*

Before School (starts at 7:30am)After School (ends at 5:30pm)
What time do you expect to pick your student up?
Please select time for drop off or pick-up:*

7:30am3:00pm4:30pm5:30pm
Who will be picking your child up?*
Relation to student*
Mobile Number for person picking up*
Please enter a valid phone number.
Please share any allergies or special instructions that Extended Care Teachers should be aware of.*
Additional Comments
Should be Empty:

EARLY CHILDHOOD Extended Care Drop-in Request Form