|
Child Learning Center |  |
| After School Enrichment Program |
2011-12
STUDENT REGISTRATION
Kindergarten through 8th Grade After School Enrichment Program housed at Big Rapids Middle School
(PLEASE USE A SEPARATE FORM FOR EACH STUDENT)
| Student’s Name | Date of Birth | ||
| School Attending 2011-12 | Grade in School 2011-12 | ||
| Parent Signature(s) | Home Phone # | ||
| Parent Name(s) | Work Phone # | ||
| (Please print) | Mobile Phone # | ||
| Home Address | Emergency Phone # | ||
| (Street) | |||
| City and Zip | |||
| (City & Zip Code) |
Fee Schedule*
(This fee provides the staff, the snack and supplies for the classes.)
Parents must pay a fee for students to participate. Fees must be paid in advance for students to attend. The following fee schedule provides for a significant discount for pre-payment for the program. Cost per student is as follows:
| $ 20.00/week | $ 70.00/Month | $ 140.00/Quarter | $ 280.00/Semester | $ 555.00/Year |
| A fee payment ($20.00 minimum) must accompany this form in order to enroll in the program. |
*Note: Daily rates ($5.00 per day) are also available.
PLEASE MAKE CHECKS PAYABLE TO: BIG RAPIDS PUBLIC SCHOOLS.
TRANSPORTATION – all students will be able to ride the shuttle busses from their elementary schools to the Middle School at the end of each school day. However, there will be no bus home at the end of the CLC Program – parents will have to pick up students at the end of CLC at the Middle School.
Please return this form along with payment to your student’s school office or to the Superintendent’s Office.