Before Care and After Care Form

Before Care and After Care Form
Before Care is $5.00 Per day (per child)
After Care is $15.00 Per day (per child)

Available hours for Extended Care
Before Care: 8:00 – 9:00 am
After Care: 3:00 – 6:00 pm

Extended care can be added at any time by paying on this form a week in advance. Cancellations less than one week in advance will not be reimbursed.
Camper #1
Campers Name (1)
First NameLast Name
Before Care List Dates (#1)
Total Amount of days you need Before care (#1)*
please click on the correct number
After Care List Dates (#1)
Total mount of days you need After Care (#1)*
please click on the correct number
Camper #2
Campers Name (#2)
First NameLast Name
Before Care List Dates (#2)
Total Amount of days you need Before care (#2)*
please click on the correct number
After Care List Dates (#2)
Total mount of days you need After Care (#2)*
please click on the correct number
Processing information
Parents Name
First NameLast Name
Phone Number
Area CodePhone Number
E-mail

Payment

Credit Card

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Total Amount you will be charged today
$0.00 USD
If you are having any difficulty processing your online payment,
please contact the office at 440 498 9533 or email: [email protected]
Should be Empty:

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Camper #1