|
Lowpoint-Washburn
C.U.S.D. #21
21st
Century
Community
Learning
Center
Grant
After-School Program
ENROLLMENT
AGREEMENT
1.
I understand that I am enrolling my child(ren) for the current school
year, and that I may withdrawal my child(ren) at any time.
2.
I understand that the After-School Program is open according to the
official school calendar of Lowpoint-Washburn C.U.S.D. #21 Schools, and is
closed during vacations, scheduled early dismissals, and inclement weather days.
3.
I understand that in the event of any absences, including absence due to
illness during the program hours, I will be responsible for contacting the
program coordinator.
4.
The program staff will assume full responsibility for my child(ren) from
the time he/she arrives at he program until he/she leaves the program according
to the written instructions for departure.
5.
If a medical emergency arises, the program staff will first attempt to
contact me. If I cannot be reached,
the staff will contact my child’s doctor.
If the emergency is such that immediate hospital attention is necessary,
an ambulance or emergency vehicle may take my child to the hospital.
I
agree to adhere to the stated policies and procedures of the Lowpoint-Washburn
C.U.S.D. #21 After-School Program as stated here and in the Policies and
Procedures Handbook, and give my
child permission to participate fully in this program.
Date
Signature
Relationship to the Child
Submit
this completed statement accompanied with the completed enrollment forms to the
After-School Program Coordinator.
|
