McDonald After School Enrichment Enrollment

After School Enrichment for 2026

Pick up at McDonald International

Student Enrollment Form

223 NE 65th St. - Seattle, WA 98115

www.littleexplorersseattle.com

Student Name

First NameLast Name

Student birthday

Date

Student grade in September 2026

Student address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Please select the days of the week you would like your child to attend. Monthly tuition rates are as follows: 2 days per week-$345 | 3 days per week-$425 | 4 days per week-$515 | 5 days per week-$605. Tuition is paid September through June and is divided into 10 equal payments with holidays and breaks taken into account. Payments are due each month no later than the 1st of the month. There is no credit for missed days.

Parent / Guardian 1

First NameLast Name

Email

example@example.com

Cell phone

Area CodePhone Number

Work phone

Area CodePhone Number

Address (if different from student)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent / Guardian 2

First NameLast Name

Email

example@example.com

Cell phone

Area CodePhone Number

Work phone

Area CodePhone Number

Address (if different from student)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Emergency Contact - Contacted if Parents or Guardians cannot be reached

First NameLast Name

Email

example@example.com

Cell phone

Area CodePhone Number

Work phone

Area CodePhone Number

Others who have permission to pick up your child

Does your child have any immunization exemptions? If yes, please explain.

Upload student's immunization records.

Browse Files

Does your child have any allergies or health concerns?

Does your child have any dietary restrictions?

Consent for medical treatment for your child:

I give permission for my child to be given emergency treatment by a licensed health care provider at the nearest emergency center. When I cannot be contacted, I authorize medical, surgical and hospital care, treatment and procedures to be performed for my child by a licensed health care provider when deemed necessary or advisable by a medical professional to safeguard my child’s health. I also give permission for my child to be transported by ambulance to an emergency center for treatment.

Please sign

Permission for walks and trips to park

I give permission for my child to go on walks and to parks in the Green Lake neighborhood.

Please sign

Were you referred to our program by a current Little Explorers family? If yes, please share their name.

What date would you like your child to start?

Does Little Explorers have permission to share your email address with other Little Explorers families?

Does Little Explorers have permission to post pictures of your child on our Facebook, Instagram and/or Google page?

Please feel free to use the space below for any additional information.

Thank you for your registration!