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Extended Day Registration
  • Student Information
  • Family Information
  • Emergency Contact Information
  • Pick Up Authorization
    In addition to parents listed above, please give the names and phone numbers to whom the child may be released.
  • Please list anyone who CANNOT pick your child up from Extended Day:
  • Medical History
    Are there any physical (i.e. allergies) and/or emotional conditions, medications, or any other medical information that the staff should be made aware of?
  • Please give any information concerning your child which will be helpful in his/her experience in a group setting (playing, eating, sleeping habits, specific fears, special likes and dislikes, etc.):

  • Rates and Fees
    There are various rates and fees related to the services provided by Extended Day. These fees, explained below, have been designed to be as equitable and as low as possible. Please note that all fees are fixed rates that begin at sign-in. We do not charge by the hour or prorate fees. Monthly invoices will reflect all appropriate charges.
    All charges are done by monthly draft. Please complete the draft form found HERE and return it to the business office.
    Late Fee: $1.00 per minute, billed through the Business Office
  • By clicking below, I acknowledge that I have read, understand and agree to abide by all aspects of the Extended Day program, including parental and student expectations as outlined in the Extended Day portion of the handbook.
    I agree that the school may authorize the physician of choice to provide emergency care in the event that neither I, nor any other contact listed or the family physician, can be contacted immediately.