Child Care Registration Form

1/2 Day Aftercare Registration

Sunrise Scholars By Team LCF, Insured & Lead By NY Licensed Childhood/SWD Educators
Child Registration Form
Name

First NameLast Name
Birth Date

MonthDayYear
Date
Child's Likes & Dislikes
Children Attending (If More Than 1 Child) Please List All Names & His/Her Grade Level.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Gender
What time do you need aftercare until?

Other
Grade
Dates of Attendance
Parent Information
Name

First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Is There Any Adult That May Not Pick Your Child Up?
Emergency Contact 1
In the event of an emergency, please contact:
Name

First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Place of Work
Other people authorized to pick up child from school
Name

First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Please list any of the following: Current medications, medication allergies, food allergies, chronic health concerns, or anything else you deem as important for us to know?
If you have nothing to share, please write N/A
March 12, 2026 Parent-Teacher After-Care
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03/12/2026
Price for One Day of Aftercare

$50.00



03/12/2026 Sibling Price
Siblings with Discounted Pricing (2 children)

$75.00 Quantity



3/12/2026 Sibling Price
Siblings with Discounted Pricing (3 children)

$90.00 Quantity



Total

$0.00
Payment Methods

Choose from one of the PayPal options to make your payment.
Should be Empty:

1/2 Day Aftercare Registration

Child Registration Form

Parent Information

March 12, 2026 Parent-Teacher After-Care *

Payment Methods

March 12, 2026 Parent-Teacher After-Care