HOCAS Flex Day Sign-Up

HOCAS Flex Day Sign-Up

Select the days you’d like to enroll your child, confirm extended-day needs, and provide guardian and student details.
Child's First and Last Name

First NameLast Name
Do you need an earlier drop off time than 8 AM?
What dates do you need the flex days service?
Does your child have any allergies?
If yes, please list all allergies
Is your child on any medication?
Child's Age
What school is your child enrolled in?
Parental Guardian's Full Name

First NameLast Name
What is your relationship to the child?
Parental Guardian's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parental Guardian's Email Address
example@example.com
Parental Guardian's Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Additional Parental Guardian Information
Additional Parental Guardian's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Additional Parental Guardian's Email Address
example@example.com
Additional Parental Guardian's Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
What is your relationship to the child?
Emergency Contact

Please provide an alternate contact for your child.
Emergency Contact's Full Name

First NameLast Name
What is your relationship to the child?
Emergency Contact's Email Address
example@example.com
Emergency Contact's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact's Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
May we release photos of your child?
Meal and Sunscreen Acknowledgment

I agree to send meals for my child for breakfast, lunch, and dinner. They understand that snacks will be provided throughout the day. By signing, I understand that sunscreen and bug repellent can be sent, but cannot be applied by a staff member.
Authorized Pick-Up Person(s)
Any additional needs or notes for staff?
Should be Empty:

HOCAS Flex Day Sign-Up

Additional Parental Guardian Information

Emergency Contact