Extend After School Pick-up Time

Extended After School Pick up Registration Form

Please note that this program is only available to our current students. To ensure we have all the necessary information for each student, please complete a separate form for each child you are registering. The cost is $25 for a single day or $150 for the entire month.Extended hours are available from 6-7 PM, Monday through Thursday, except on Fridays.Thank you!
Parent Name*

First NameLast Name
Student Name*

First NameLast Name
Email*
example@example.com
Phone Number
Please enter a valid phone number.
Would You like to register your child for daily or Monthly

Daily Cost $25 (pay by this registration)Monthly Cost $150.00 Monthly (pay by this registration)
Monthly Extended After School Program

October 2024November 2024December 2024January 2025February 2025March 2025April 2025May 2025June 2025
write Days
Note to Staff:
please let us know if you have any questions, concerns or requests.

My Products*

Daily FeePick how many days do you need?

$ Free Quantity

Monthly Fee

$ Free Quantity

Enter coupon

Total

$0.00

Payment Methods

Debit or Credit Card

First Name

Last Name

Credit Card Number

Card Expiration

Security Code

Please click one of the PayPal options to complete payment and submit the form.

Extended After School Pick up Registration Form