St. Mary’s Extended Day Care Registration

Registration for 2011 - 2012

Childs Name*
FirstLast
Child's Grade
Mother's Name
FirstLast
Mother's Phone
Father's Name
FirstLast
Father's Phone
Emergency Contact
FirstLast
Emergency Phone
Emergency Contact
FirstLast
Emergency Phone
Special Medical Concerns
REGISTRATION FEE - $25.00 (NRF) PER FAMILY
Type of Care
- Before Care Only (7:00 - 7:45 am) $25.00 per week
- Before Care Drop-in Care (payable immediately) $ 6.00 per hour or any part thereof
- After Care Only (dismissal - 6:00 pm ) $55.00 per week
- After Care Drop-in Care (payable immediately) $ 6.00 per hour or any part thereof
- Before & After Care $65.00 per week
Siblings registered in this program receive a $10.00 per week discount. Payment is due weekly on the first day of care. The program ends daily at 6:00pm. Any late pick-ups will be assessed @ $1.00 per minute which is payable upon arrival. If you anticipate a late pick-up, please call the school at 301-498-1433 ext 411.
Your Name
FirstLast
Signature*
I completely understand and will comply with the above day care policy.
Your Email*