St. Elizabeth Catholic School

REGISTRATION FORM ~ EXTENDED SCHOOL

PROGRAM      2007-2008

 

 

I, ____________________________________, want to register my child/children for the Extended School Program for the 2007-2008 academic year.

                                                                Please circle which care you need:

 

 

___________________________________     Before Care      After Care        After Care

Student                                     Grade                                             (5 days)           (3 days)

 

 

___________________________________     Before Care      After Care        After Care

Student                                     Grade                                             (5 days)           (3 days) 

 

 

___________________________________     Before Care      After Care        After Care

Student                                     Grade                                             (5 days)           (3 days)

 

  

___________________________________     Before Care      After Care        After Care

Student                                     Grade                                             (5 days)           (3 days)

 

 

Enclosed, please find a check in the amount of $________________ ($50.00 per child) for a deposit for my child/children which is non-refundable.

 

If you choosing three days, which days would you be interested in?

 

________________________, ________________________, _____________________ 

 

 

Parent Signature                                                                                                Date

 

Received by __________________________________________

                     Name                                                      Date

 

Check number _________________                Amount  ______________________