Grace After Hours - Registration
Please complete a separate form for each child you are registering.
Personal Information
Child First Name
*
Child Last Name
*
Contact Email
*
Grade
*
Select One
PK
JK
SK
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Password
*
Re-enter
*
Parent First Name
*
Parent Last Name
*
Address
*
Zip Code
*
Home Phone
*
Cell Phone
*
Parent First Name
Parent Last Name
Address
Zip Code
Home Phone
Cell Phone
If parents are divorced or separated, who maintains legal custody?
Joint
Parent 1
Parent 2
Emergency Contacts
Name
*
Phone
*
Name
*
Phone
*
Family Physician
*
Phone
*
Please list all the names of people authorized to pick your child up.
Enrollment Fees
Monthly
Semester
PK & JK
SK - 6
PK & JK
SK - 6
3 days/week (until 3:00) 3day PK only
$155
$697.50
3 days/week (until 6:00) 3day PK only
$215
$967.50
5 days/week (12:00 - 3:00)
$190
$855
5 days/week (until 6:00)
$250
$190
$1,125
$855
DROP-IN RATES
: $7.00 per hour (children enrolled on a drop-in basis)
HOLIDAY CARE RATES
: Regular Students $35.00 per day Drop-in Students $45.00 per day
Please check number of days desired per week:
*
5 Days
3 Days (PK only)
Drop-in
Carpool (SK only)
PRESCHOOL PARENTS
My child will stay in ASC until:
3:00
6:00
Payments will be made:
*
Monthly
Per Semester
Yearly
