After School Care Registration Form Step 1 of 3 33% WOS After School Care Registration The Way of the Shepherd Catholic Montessori School understands that families have many responsibilities. To assist families who need after school care, we are pleased to offer on-sight after school care. The after school program runs from 3 p.m. to 6 p.m. on school days. Care is not provided on non-school days. After Care will begin on the Tuesday August 30 (for students in grades 1-8) and after Labor Day for CH students and will continue until the last full day of school. Families may join the program at any time by completing this contract. Contracts begin upon submission and continue until the end of the school year. Payments are due by the tenth of each month. The Way of the Shepherd reserves the right to end the program if enrollment declines to fewer than 10 children by August 30th. In this event, families with after care contracts will be given notice and have two weeks before the program ends. How many children would you like to register for after school care?*123456Parent Name Email STUDENT INFORMATIONChild's Name* First Last Nickname (if applicable) Birthdate* MM slash DD slash YYYY Age as of Sept 1* Special Learning Needs?* Yes No Special Learning Needs*Allergies?* Yes No Allergies – Type and severity*APPLY FOR ANOTHER CHILD?* Yes No STUDENT #2 INFORMATIONChild's Name* First Last Nickname (if applicable) Birthdate* MM slash DD slash YYYY Age as of Sept 1* Special Learning Needs?* Yes No Special Learning Needs*Allergies?* Yes No Allergies – Type and severity*APPLY FOR ANOTHER CHILD?* Yes No STUDENT #3 INFORMATIONChild's Name* First Last Nickname (if applicable) Birthdate* MM slash DD slash YYYY Age as of Sept 1* Special Learning Needs?* Yes No Special Learning Needs*Allergies?* Yes No Allergies – Type and severity*APPLY FOR ANOTHER CHILD?* Yes No STUDENT #4 INFORMATIONChild's Name* First Last Nickname (if applicable) Birthdate* MM slash DD slash YYYY Age as of Sept 1* Special Learning Needs?* Yes No Special Learning Needs*Allergies?* Yes No Allergies – Type and severity*APPLY FOR ANOTHER CHILD?* Yes No STUDENT #5 INFORMATIONChild's Name* First Last Nickname (if applicable) Birthdate* MM slash DD slash YYYY Age as of Sept 1* Special Learning Needs?* Yes No Special Learning Needs*Allergies?* Yes No Allergies – Type and severity*APPLY FOR ANOTHER CHILD?* Yes No STUDENT #6 INFORMATIONChild's Name* First Last Nickname (if applicable) Birthdate* MM slash DD slash YYYY Age as of Sept 1* Special Learning Needs?* Yes No Special Learning Needs*Allergies?* Yes No Allergies – Type and severity* AFTER SCHOOL PLAN Pricing per child with care from 3:00-6:00 PM 1 day a week at $65 per month2 days a week at $126 per month3 days a week at $168 per month4 days a week at $210 per month5 days a week at $260 per month Please select your After School Plan: 1 day a week at $65 per month 2 days a week at $126 per month 3 days a week at $168 per month 4 days a week at $210 per month 5 days a week at $260 per month 1 day a week price $2 day a week price $3 day a week price $4 day a week price $5 day a week price $Total Due*Start date* MM slash DD slash YYYY Indicate which days you need (these can change as needed throughout the year)* Mondays Tuesday Wednesday Thursday Friday Program InformationAfter care is only available to students enrolled at The Way of the Shepherd. Children should bring a snack and water bottle to enjoy during after care hours. WOS after-school care will be planned and supervised by Ms. Ethel Smith, a former Children’s House Guide. After dismissal, children will report to the aftercare classroom. They will eat their snack followed by educational and creative arts activities as well as time outdoors (weather permitting). In Case of Emergency:*NameRelationshipPhone Click ⊕ sign to add a new rowPermission for After-School Care:* I grant permission for the above named in this activity and I warrant that my child(ren) is/are in good health. In consideration of my child(ren)’s participation, I agree to indemnify the school and the Archdiocese of St. Paul & Minneapolis from any claims or law suits brought against the school or the Archdiocese of St. Paul & Minneapolis by myself, my child(ren), or others, that arises out of any behavior by my child(ren) during after-school care. I also agree to pay reasonable attorney’s fees or expenses incurred by the school and the Archdiocese in defense of such a claim/suit. Signature* Reset signature Signature locked. Reset to sign again Date* MM slash DD slash YYYY
