Trojan 6 to 6 Extended Care Enrollment Agreement

Please list all children that will attend the Trojan 6 to 6 Extended Care Program.

Child 1 - Full Name*

Child 1 - Birthdate*

Child 1 - Grade*

Child 1 - Gender*

Child 2 - Full Name

Child 2 - Birthdate

Child 2 - Grade

Child 2 - Gender

Child 3 - Full Name

Child 3 - Birthdate

Child 3 - Grade

Child 3 - Gender

Child 4 - Full Name

Child 4 - Birthdate

Child 4 - Grade

Child 4 - Gender

List any additional children attending the 6 to 6 program.

Attendance Information

***NOTE: Emergency Coverage Need Only: Please contact Elementary Main Office when needing Before or After School Care on SHORT NOTICE Only 641-483-2671.

Before School Care 6:00am-8:00am

Please check the days your child(ren) will attend 6 to 6 Before School Care. **5 days $20, **4 days $17, **1-3 days $14.

Monday
Tuesday
Wednesday
Thursday
Friday

After School Care 3:25pm-6:00pm

Please check the days your child(ren) will attend 6 to 6 After School Care. **5 days $27, **4 days $22, **1-3 days $16

Monday
Tuesday
Wednesday
Thursday
Friday

Preschool Wrap Around Care 8:00am-3:25pm

Please check the days your child(ren) will attend Preschool Wrap Around Care. **5 days $102, **4 days (M, Tu, Th, F) $72, **1-3 days (M/Tu/Th/F) $20 per day, **full-day Wednesday $30

Monday
Tuesday
Wednesday (full day)
Thursday
Friday

Scheduled Early Dismissal Days*

Scheduled Early Dismissals Only (1:00-6:00) *7 day notice required. *Any child who is already enrolled to attend after school will be billed an additional $5 early-out fee *Any child who attends ONLY early out days (1:00-6:00 PM) will be charged $11 each early out.

Yes
No

Drop-In Care

*Drop-in Care requires a 48-hour notice and will be charged the 1-3 day rate.

Yes
No

Drop-In Care

Please Specify Days of the Week or Any Additional Information for drop-in care.

Please check the boxes to indicate that you have read the statements below.

If your child is enrolled in Before School Care and will be having school breakfast, families must deposit money into the student meal account (it is not included in weekly charge) or you may apply for free/reduced price meals.*

I have read and understand this statement

If your child is enrolled in Preschool Wrap Around Care and will be having school lunch, families must deposit money into the student meal account (it is not included in weekly charge) or you may apply for free/reduced price meals.*

I have read and understand this statement

There will be no After School Care on Parent-Teacher Conferences days. Preschool Wrap Around Care will end at 2:20 those days.*

I have read and understand this statement

On days that school is cancelled due to inclement weather, there will be no Trojan 6 to 6 Extended Care.*

I have read and understand this statement

On days when there is an early dismissal due to inclement weather, children must be picked up as soon as possible.*

I have read and understand this statement

On days when there is a late start due to inclement weather, Trojan 6 to 6 Extended Care will be open for those enrolled in Before School Care. If the delay becomes a cancellation, children will need picked up as soon as possible.*

I have read and understand this statement

There will be no Trojan 6 to 6 Extended Care on scheduled no-school days, including winter break and spring break.*

I have read and understand this statement

You may pay through JMC or pay by check when you drop off/pick up your child(ren).*

I have read and understand this statement

Charges will be based on enrollment, unless at least two weeks notice is given of schedule change.*

I have read and understand this statement

If payment is 1 week late, child(ren) are not allowed to attend until payment is received or arrangements are made at the District Office.*

I have read and understand this statement

Electronic signature of parent or legal guardian completing this agreement*

Date*

Trojan 6 to 6 Extended Care Enrollment Agreement

Trojan 6 to 6 Enrollment Agreement

Please list all children that will attend the Trojan 6 to 6 Extended Care Program.

Attendance Information

Please check the boxes to indicate that you have read the statements below.