Christmas Holiday Care Registration

December 2011

Student Name:
Grade:
Guardian's Name:
Business Phone:
Cell Phone:
Emergency Contact:
Emergency Phone:
Allergies:
Email:
Extended Care will be open the following days for Christmas break. The fee for each registered day regardless of attendance is $28. There is a $10 late fee for those registering after Friday, December 9, 2011 or for those attending and not registered.
ALL CHILDREN NEED TO BRING THEIR LUNCH EACH DAY -- DRINKS AND SNACKS WILL BE PROVIDED.
Indicate which day(s) your child will be attending with an 'X'.
Tuesday, December 13 (11:00 a.m. dismissal-Teacher Work Day-$23):
Friday, December 16 (11:00 a.m. dismissal-$23):
Monday, December 19:
Tuesday, December 20:
Wednesday, December 21:
Monday, December 26:
Tuesday, December 27:
Wednesday, December 28:
Thursday, December 29:
CLOSED: Thursday, December 22; Friday, December 23, Friday, December 30 and Monday, January 2.
Security Code:
When you submit this form it will be emailed to Beverly Willis.