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COMMUNITY Resources for Enrolled Families Back to School Forms

After Care Enrollment Form

Aftercare Program will be held until 5:00 pm Mon-Thurs when school is in session ONLY (days before yom tov and Thanksgiving excluded).

On Fridays, Aftercare is offered for 1 hour after the close of school.

Cost: The rate for students and drop-ins will be $5.00 per hour in half hour increments. Billing begins 10 minutes after dismissal. Students who are not picked up on time will have to pay $1.00 for each additional minute. This payment will be billed to you by the business office.

Supervisors:
Elementary School - Rabbi Popack
Preschool - Chanie Perelmuter

Location:
Elementary students - Library Area
Preschool students - Preschool
Family Name*
Number of Students*
Name of Student (1)*
First Name Last Name
Grade
Name of Student (2)
First Name Last Name
Grade
Name of Student (3)
First Name Last Name
Grade
Mobile Number

Area Code Phone Number
Emergency Contact (1)*
Prefix First Name Last Name
Emergency Contact Number (1)* Cell Preferred

Area Code Phone Number
Emergency Contact (2)*
Prefix First Name Last Name
Emergency Contact Number (2)* Cell Preferred

Area Code Phone Number
Should be Empty:

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