After School Care Registration Use Form

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After School Care Registration

2026-2027 School Year

"*" indicates required fields

This field is for validation purposes and should be left unchanged.
Family Last Name*
Please check the box ONLY if you intend to use ASC on an as needed basis.
Please remember: Reservations and payment should be made by Thursday of the week before care is needed.

Student Information

Name*
Please indicate the days that each student will regularly attend ASC.
Name
Please indicate the days that each student will regularly attend ASC.
Name
Please indicate the days that each student will regularly attend ASC.
Name
Please indicate the days that each student will regularly attend ASC.
Name
Please indicate the days that each student will regularly attend ASC.
This may include details related to allergies, custody arrangements, etc.
Approved Pick Up List*
Please provide the names of all people (PARENTS INCLUDED) who may pick up this child/these children from After School Care. Use the (+) symbol to add multiple names.
Name
Relationship
Cell Phone Number
 
Consent*