Facebook-f
We're Hiring!
Inquire Now

Afterschool Application

Student’s Name:(Required)
Prices:(Required)
Parent/Guardian Name:(Required)
Parent/Guardian Name:
Student’s Address:(Required)
Child’s Date of Birth:(Required)
MM slash DD slash YYYY
ELC:(Required)

Method of Payment:

All payments will be processed through Brightwheel.

Tuition is billed each Monday.

Consent(Required)
MM slash DD slash YYYY
If parents cannot be reached in an emergency situation, the following people should be contacted:(Required)
Name
Phone #
Alternate Phone #
 

TRANSPORTATION AUTHORIZATION

in Gallop’s Family Center Inc. vans.
MM slash DD slash YYYY

RECEIPT OF CHILDCARE POLICIES

I have received and understand all the childcare policies provided to me in this registration packet. I agree to adhere to all policies and procedures outlined in this packet.
MM slash DD slash YYYY

PHOTO RELEASE

will mark the space below to grant or not grant permission of photos of my child to be used in the manner below.
Use still photos in promotional materials(Required)
Display still photos on facility’s website(Required)
Display in facility’s bulletin boards, show to current and prospective clients(Required)
​​​© 2024 Gallop’s Family Center, Inc. All Rights Reserved | Privacy Policy | Powered By GYC Logo Grow Your Center