CHILD(REN)'S NAME?SGRADE

GRADE

GRADE

PARENT/GUARDIAN'S NAME

ADDRESSCITY

HOME PHONEZIP CODE

OPTION SELECTED: Please indicate one of the following options

I- 7:00 - 8:05 a.m.

$ 90.00 per month

 

II- 2:30 - 4:00 p.m.

$ 100.00 per month

 

III- 2:30 - 5:00 p.m.

$110.00 per month

 

IV- 2:30 - 5:30 p.m.

$ 125.00 per month

 

V- 2:30 - 6:00 p.m.

$ 135.00 per month

 

Options I and II

$ 190.00 per month

 

Options I and III

$ 200.00 per month

 

Options I and IV

$215.00 per month

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Options I and V

$225.00 per month

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Drop-In

$8.00 per hour

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Fees are payable on a monthly basis and are due on the first day of each month, September through May.

There is no after-school care provided on the day prior to Christmas and Easter breaks, on days when the LEAD personal must attend school-related functions, or when classes are not in session.

THERE WILL BE A LATE PICK-UP FEE OF $5:00 FOR EACH FIFTEEN MINUTES AFTER 6:00 p.m.

NOTE: We require that parents arrange alternative child care plans in case of an emergency, severe weather, student illness, days when after-school LEAD is not in session, etc. Due to increase problems experienced, we will exclude children from LEAD for seriously disruptive behavior, repeated failure of parents to pick up/keep sick children home, or repeated late pick up when no phone contact has been made by a parent to LEAD personnel.

Both before and after-school LEAD Programs begin on August 26, 2008 and end on June 8, 2009. Children are asked to bring a healthy snack and a book to read daily.

A non-refundable $10.00 registration free must accompany this application, which should be returned to the school office no later than Monday, Aug.18 2008. Applications received after this date will be honored only as space and staffing is available.

 

I/We agree to abide by the school rules and regulations stipulated for the LEAD Program as described above.

Signature

Date

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