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After-Care Registration Form

- Admissions

Our After-School Care is open to all students PS3-8^th who are in attendance all day at Curé of Ars. Hours are 3:30 PM to 6:00 PM on days that we are in school. There is no After-School Care on early dismissal days. You may choose 2 days, 3 days, or 5 days a week. Drop-in is available also. To enroll in After-Care, please complete the below form and pay the registration fee while paying your instructional fes.
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- Student 1
  
  Student 1 - First and Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Student 1 - Homeroom Teacher REQUIRED Please fill out this field. Please enter valid data.
  
  Student 1 - List each day After-Care is needed for this student and if needed Full Time, Part Time, or Drop In REQUIRED Please fill out this field.
  
  Student 1 - Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Student 1 - List any Allergies
- Student 2 (Skip to parent information if only registering one student)
  
  Student 2 - First and Last Name Please enter valid data.
  
  Student 2 - Homeroom Teacher Please enter valid data.
  
  Student 2 - List each day After-Care is needed for this student and if needed Full Time, Part Time, or Drop In
  
  Student 2 - Date of Birth Please enter valid data.
  
  Student 2 - List any Allergies
- Student 3
  
  Student 3 - First and Last Name Please enter valid data.
  
  Student 3 - Homeroom Teacher Please enter valid data.
  
  Student 3 - List each day After-Care is needed for this student and if needed Full Time, Part Time, or Drop In
  
  Student 3 - Date of Birth Please enter valid data.
  
  Student 3 - List any Allergies
- Student 4
  
  Student 4 - First and Last Name Please enter valid data.
  
  Student 4 - Homeroom Teacher Please enter valid data.
  
  Student 4 - List each day After-Care is needed for this student and if needed Full Time, Part Time, or Drop In
  
  Student 4 - Date of Birth Please enter valid data.
  
  Student 4 - List any Allergies
- Guardian/Mother's Information
  
  First and Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Work Phone Number Maximum 20 characters Please enter a phone number.
  
  Home Phone Number Maximum 20 characters Please enter a phone number.
- Guardian/Father's Information
  
  First and Last Name Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Email Please enter an email address.
  
  Cell Phone Number Maximum 20 characters Please enter a phone number.
  
  Work Phone Number Maximum 20 characters Please enter a phone number.
  
  Home Phone Number Maximum 20 characters Please enter a phone number.
- Emergency Contact Information
  
  Emergency Contact's First and Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact's Relationship to Child REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact's Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Pick Up List
  
  List of adults with permission to pick up student(s): REQUIRED Please fill out this field.
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Curé of Ars Catholic School

Leawood, KS

After-Care Registration Form