Editing previous response:

Please fix the highlighted areas below before submitting.

Before School Childcare Registration Form

Child's Name*

Child's Grade and Homeroom*

Please complete the form below. Required fields marked *

Allergies*

Days Expected to Use Morning Care*

Monday

Tuesday

Wednesday

Thursday

Friday

Other:

Parent's Contact Information (Name, Email Address, Phone Number)*

Emergency Contact Information (Name, Relationship to Child, Email Address, Phone Number)