Our new procedure to specify Before and After School Care for:

    • ThumBelina
    • Juniors and Seniors Preschool
    • Stay and Play Club (for Lakeland School District Kids)

We have created new Before and After School Care monthly forms for you to specify your schedule and cost. Please obtain your copy from our office for the next month or download the Monthly Form below.

There are forms devoted solely to Tom Thumb students (ThumBelina, and Junior & Senior Preschool) that are provided by our office or may be downloaded below on the left.

There are forms for just for Stay and Play Club (for Lakeland School District Kids) that are provided by our office or may be downloaded below on the right. To learn more about our Stay and Play Club, Before/After School Care for students attending Lakeland Elementary School, click on our Stay and Play Club Tuition Rate.

Brief Instructions to Complete the Monthly Forms

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

complete before and after school PDF form

2023 – 2024 Monthly Before and After School Care Forms

Each Monthly Form is a PDF file that contains the Before School Care section on the left and the After School Care on the right, both on the front page. Download and print the form with our published pricing and complete each appropriate section to suit your needs. To download the Monthly Forms below, click on the phrase, Click Here to Download:

Monthly Forms for ThumBelina Students

Before & After School Care for
Two Year Old Students

September Monthly Form for ThumBelina StudentsClick Here to Download

October Monthly Form for ThumBelina Students​ – Click Here to Download

November Monthly Form for ThumBelina Students Click Here to Download

December Monthly Form for ThumBelina Students​ – Click Here to Download

January Monthly Form for ThumBelina Students Click Here to Download

February Monthly Form for ThumBelina Students​ – Click Here to Download

March Monthly Form for ThumBelina Students ​- Click Here to Download

April Monthly Forms for ThumBelina Students​ – Click Here to Download

May Monthly Form for ThumBelina Students​ – Click Here to Download

June Monthly Form for ThumBelina Students​ – Click Here to Download

Monthly Forms for Tom Thumb Students

Before & After School Care for
Juniors & Seniors Students

September Monthly Form for Tom Thumb Juniors and Seniors StudentsClick Here to Download

October Monthly Form for Tom Thumb Juniors and Seniors Students​ – Click Here to Download

November Monthly Form for Tom Thumb Juniors and Seniors StudentsClick Here to Download

December Monthly Form for Tom Thumb Juniors and Seniors Students​ – Click Here to Download

January Monthly Form for Tom Thumb Juniors and Seniors Students Click Here to Download

February Monthly Form for Tom Thumb Juniors and Seniors Students​ – Click Here to Download

March Monthly Form for Tom Thumb Juniors and Seniors Students ​- Click Here to Download

April Monthly Form for Tom Thumb Juniors and Seniors Students​ – Click Here to Download

May Monthly Form for Tom Thumb Juniors and Seniors Students​ – Click Here to Download

June Monthly Form for Tom Thumb Juniors and Seniors Students​ – Click Here to Download

Monthly Forms for Stay and Play Club

Before & After School Care for
Lakeland Elementary Students

September Monthly Form for Stay and Play ClubClick Here to Download

October Monthly Form for Stay and Play ClubClick Here to Download

November Monthly Form for Stay and Play ClubClick Here to Download

December Monthly Form for Stay and Play ClubClick Here to Download

January Monthly Form for Stay and Play ClubClick Here to Download

February Monthly Form for Stay and Play ClubClick Here to Download

March Monthly Form for Stay and Play ClubClick Here to Download

April Monthly Form for Stay and Play ClubClick Here to Download

May Monthly Form for Stay and Play ClubClick Here to Download

June Monthly Form for Stay and Play Club  – Click Here to Download

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