Free Before and After Care Registration Form Template
Before and After Care Registration Form
Please fill out this form to register for before and after care services for your child.
Parent/Guardian Information
Name
Phone number
Child Information
Name
Date of Birth
School Attending
Grade
Before Care
Required?
Drop-Off Time
Any Special Instructions
After Care
Required?
Pick-Up Time
Any Special Instructions
Emergency Contact Information
Name
Phone number
Relationship to Child
Authorization
By signing below, I authorize the use of the information provided above for the purpose of before and after care registration. I also agree to abide by all applicable policies and procedures related to the care provided.
Name:
Date:
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