JK-GRADE 5 BEFORE CARE PROGRAM

JK-Grade 5 Before Care Program (7:30 to 8:00 a.m.)

Yes, I wish to enroll my daughter(s) in the JK-Grade 5 Before-Care Program

Parents First and Last Namerequired

Phone Numberrequired

Child's Name and Grade required

Child's Name and Grade

Please indicate which day(s) of the week your daughter(s) will be attending the program:*

The cost of the Before Care Program is $895 per student, (pro-rated, if necessary) billed to your account as follows:

September 27, 2021 - $300
January 31, 2022 - $300
March 28, 2022 - $295

Payment*

I understand that the fee for this service is $895 and will be billed to my Elmwood account. (Pro-rated, if necessary).

Before Care Program ($895) Pro-rated if necessary

Pick Up: Please indicate the authorized person(s) below to pick up your daughter (List first and last names as they would be shown on government identification):

Name and Relationship to Studentrequired