Bright Ideas Learning Community LLC
4K After Care Registration Form
Child's Name _______________________________________ DOB ___/___/___
Parents' Names ______________________________________________________
Address ______________________________________________________________
City _______________________ Zip ________________
Phone # _________________________________
Alt. Phone # _____________________________
Email ________________________________________________________________
Please mark the days and times for which you would like to contract care.
___ MON ___ TUE ___ WED ___ THU ___ FRI
4K After Care 11:15-3:45 PM (pick up by 3:15 on Thursdays) ($21 per day)
___ MON ___ TUE ___ WED ___ THU ___ FRI
Extended 4K After Care 11:15-6:00 PM ($34 per day)
___ MON ___ TUE ___ WED ___ THU ___ FRI
Spots will be reserved on a first come first served basis by returning this form to the center director with enrollment fee of $35 for new clients. Preference in availability is given to full time schedules. Please speak with the director if your schedule is less than 3 consistent days per week. Drop in care is an option based on availability.
By signing this form I agree that the above reflects the days I'd like to contract care for the 2015-2016 school year for my 4K child on regular school attendance days. Furthermore, I agree to abide by the Bright Ideas Learning Community, LLC policies as outlined in the policy manual. (A copy is available in the front hall for review.)
___________________________________________ ____________________
Parent Signature Date
Bright Ideas Learning Community, LLC
Email: brightideasLC@gmail.com
Website: www.brightideasLC.com
Location: 110 E Oak Crest Dr, Wales, WI, United States
Phone: 262-201-4278