Before & After School Care Monthly Form

Complete one Monthly Form for Each Child.

The monthly form is due on the 15th of the prior month.

• Label tote bags and lunch boxes, or our staff will.
• Each monthly form must be completed and submitted before the 15th of the prior month with your payment. For example, September’s Form is due August 15th with your check for payment, and October’s Form is due September 15th.
• Deducting, credit, or refunding for absenteeism is impossible since resources are allocated the previous month.
• We must have your child’s Emergency Contact Numbers, Medical Records & Info, and Immunization Records before the child attends the program.
• The late fee is $10 for every 15 minutes for pick-up after 5:30 pm. For emergencies, please call to let us know you will be late.
• Please give your child breakfast at home before
• The parent must complete the monthly forms and submit them to our office on time with payment.
• Complete the Top of Form
  • Print your child’s name, parent name, phone number, and 4-digit code
  • For Tom Thumb students, Circle or Select one: Junior__ Senior__ ThumBelina
  • For Stay and Play Club students, indicate the Elementary School and the grade child is in by Circle or Select One: GW__ TJ__ LT__ VC__ BF__ Grade_____
    
  • For Before-School Care
    • Check the days for the selected time slot you want for before-school care
    • Don’t cross out days your child will not attend; leave them blank.
    • Count the time slots horizontally checked for each week and enter the total in the Days column.
    • Multiply the number in Days by Cost horizontally and enter the result into the  Amt. Due column.
    • Add the vertical Amt. Due column and place the sum in the Before Care Total line item on the bottom.
  • For After-School Care
    • Check the days for the selected time slot you want for after-school care
    • Don’t cross out days your child will not attend; leave them blank.
    • Count the time slots horizontally checked for each week and enter the total in the Days column.
    • Multiply the number in Days by Cost horizontally and enter the result into the  Amt. Due column.
    • Add the vertical Amt. Due column and place the sum in the After Care Total line item on the bottom.
  • Add the Before Care Total line item with the After Care Total line item, place the sum in the Before & After School Care Total Due line item, and write a check for this grand total.
  • Return the monthly form with your check before the 15th of the prior month.
    

Example of a Completed Form