ECB Educational Center After Care Application

ECB Educational Center After Care Application

Apply for the ECB Educational Center After Care Program. Please provide student and parent/guardian information, authorized pick-up persons, and review program policies.
Student Information
Student Name
Grade
Date of Birth

MonthDayYear
Date
Parent/Guardian Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact
Emergency Contact Number
Please enter a valid phone number.Format: (000) 000-0000.
Authorized Pick-Up Persons
Authorized Pick-Up Person 1
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Child
Authorized Pick-Up Person 2
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Child
Authorized Pick-Up Person 3
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Child
Academic & Enrichment Opportunities
All students enrolled in after care are required to participate in:
- Mandatory tutoring
- Reading enhancement activities
- Homework assistance
- Academic reinforcement
Students will also have opportunities to participate in:
- Art activities
- Physical education
- STEM enrichment
- Team-building activities
- Educational games and supervised recreation
Program Information
ECB Educational Center After Care provides a safe, structured, and academically supportive environment for students after school hours.

Program Hours: Monday–Friday, School Dismissal – 6:00 PM
Weekly Tuition: $60 Per Week/ +25 per extra child. Payments are due every Monday morning.
Late Pick-Up Policy
Students must be picked up no later than 6:00 PM each day.
- A late fee of $1 per minute after 6:00 PM may be charged.
- Repeated late pick-ups may result in temporary suspension from the after care program.
- Continued failure to arrive on time may result in permanent removal from after care services.
ECB Educational Center staff members must leave promptly after program hours. Parents and guardians are expected to honor all pick-up times consistently.
Behavior Expectations
Students participating in after care are expected to:
- Follow all school and classroom rules
- Respect staff members and peers
- Participate appropriately in tutoring and enrichment activities
- Maintain safe behavior at all times
Failure to follow behavioral expectations may result in disciplinary action or removal from the program at administratuve discretion
Medical Information
Medical Information (allergies, medications, or medical concerns)
Parent Agreement & Signature
I understand the expectations, fees, policies, and procedures of the ECB Educational Center After Care Program. I agree to comply with all program requirements and understand that failure to follow policies may result in suspension or removal from after care services.
Parent/Guardian Signature
Date

MonthDayYear
Date
Should be Empty:

ECB Educational Center After Care Application

Student Information

Authorized Pick-Up Persons

Medical Information

Parent Agreement & Signature