HVA EAST 2026-2027 NEW MEMBERSHIP FORM

WELCOME!

Legacy is excited to welcome your child to the 2026-2027 after-school year. Legacy is the contract provider of after-school programs for Harlem Village Academy Charter School East. Our programs are designed to provide continuous after-school child care for scholars who attend HVA EAST in PreK-5th.This is the first step to registering your child! Please review this form carefully by reading all parts and questions!!

General Information:

This application is for scholars in PreK-5th.

Due to the short time frame of after school, the schedule below is a general insight into the program.

Monday- Thursday: (Short Days): Scholars receive a light snack and homework assistance.

Fridays: (Long Days) Scholars receive a light snack, homework assistance, arts & crafts, STEM, free play, and organized sports activities.

* Snacks are provided by the NYC Dept of Education.

Program Hours:

FIRST DAY OF PROGRAM: AUGUST 26, 2026.

Monday- Friday ( HVA DISMISSAL OR 3:30 pm-5:45 pm)

Half Days (HVA DISMISSAL OR 12:15 pm-5:45 pm)

Early Dismissal is by request and at 4:30-4:35 pm. ( Strict Policy)

Programs are dismissed at 5:15 pm daily until 5:45 pm from the auditorium.

Registration Information:

Please complete this registration form.
Sign the membership agreement.
Processing will take three business days to coordinate with HVA, as well as onboarding of the family as a member.
Download ProCare once you receive the welcome email. Membership is not finalized until you have the ProCare app.

Membership Plan Options for 2026–2027:

$225 per month for 5 days per week.
$195 per month for Friday HALF DAYS ONLY.
Sibling Discount is $20 off the monthly invoice
By registering, you will be charged for the first month of care to get started. After that, you will be billed monthly and will pay on the Procare app.

Sibling Discounts:

Sibling discounts will be applied after you have completed a form. The sibling discount is $20 per month off the total bill and will be on your Procare account starting in October or on the subsequent invoice.

This form is for one child at a time. If you need to add a sibling, please complete another form.

Vouchers: Legacy ONLY accepts 1199 SEIU AND MTA LOCAL 100 vouchers. If you have a voucher, you will still need to complete an application. Processing of vouchers will begin after the first month of care.

Expedited Processing: Parents can request expedited start by selecting the option below. This means your child can start quickly with expedited processing.

Generally, Applications take 48 hours to process. This option reduces processing time. Note: This is an additional fee for the membership specialist to expedite your application and connect with the school to get your child into the program.

If your application is recieved by 5 pm on a business day, your child may be processed to start the following day by noon.

Procare:

You will receive a notice by email or text to download the Procare app. Please sign up AND download the Procare app. Once complete, your application will be finalized.

Communication: Please provide an email that you check regularly.

You will receive an email to sign the Membership Agreement. This agreement is required, and your application is not finalized until this agreement is signed and procare is downloaded.

To communicate with Legacy due to high call volume, send a message using ProCare to the OFFICE CHAT.

Additional Questions? Email us: membership@legacyafterschool.com

Follow us on Instagram! www.instagram.com/legacyyouthorg

FINAL: Legacy programs are NON-REFUNDABLE. Therefore, completing this application will result in a charge for the first month of care.

Child's Full Name

First NameLast Name

Date of Birth

Date

Gender

Grade Entering in Fall 2026

Class

Was Your Child Enrolled in Legacy After School Programs During the 2025-2026 School Year?

Did Your Child Attend Legacy Summer Camp This Summer 2026?

Primary Parent/Guardian Full Name

First NameLast Name

Relationship to Child

Other

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Primary Parent Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Primary Parent Work Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Primary Parent Email Address

example@example.com

Parent/Guardian Full Name

First NameLast Name

Relationship to Child

I Want This Guardian To Have Permissions On My Childs Account.

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email Address

example@example.com

Authorized Parent/Guardian Full Name #1

First NameLast Name

Authorized Pick Up #1 Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Authorized Parent/Guardian Full Name #2

First NameLast Name

Authorized Pick Up #2 Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Does your child have any behavioral concerns we should be aware of?

If yes, please describe behavioral concerns

Has your child been diagnosed or recieve with any of the following services concerns? (Select all that apply)

To Best serve your child. The Legacy Office of Membership Management requires that you upload your child's IEP and or any documents that will provide support and understanding of your child while in programs.

Does your child have any medical conditions?

If yes, please describe the medical condition(s)

Does your child take any medications?

Does your child require the use of an epinephrine auto injector?

Does your child require the use of an asthma inhaler?

Does your child have any allergies?

If yes, list all allergies and describe any reactions or Medications. Note: Legacy is a nut free program and self administering site.

Early Dismissal Plan- I am requesting that my child be dismissed at the time slot requested below.

Legacy Accepts Select Child Care Vouchers and Child Care Assistance. Will You be using vouchers listed?

How did you hear about Legacy? ( Friend Name, Google, Instagram, Community?)

By completing this order, you securing membership for the child above. If you have a second child, please complete another application.

LEGACY HVA EAST MONTHLY MEMBERSHIP M-F

This is the monthly membership care plan. Monday- Friday.

$225.00

FRIDAYS ONLY- HVA EAST HALF DAYS

Select if your child will only attend on FRIDAYS.

$195.00

2006- 2027 MEMBERSHIP APPLICATION FEE

This application fee is required.

$60.00

ADMINISTRATIVE FEE

This Administrative fee is required for processing

$10.00

EXPEDITED AFTER SCHOOL ENROLLMENT LESS THAN 48 HOURS

This Administrative fee is required for processing. ONLY select if you are rushing enrollment of your child less than 48 hours.

$60.00

Total

Payment Methods

Credit Card

Apple Pay

Google Pay

Cash App Pay

LEGACY HVA EAST AFTER SCHOOL 2026-2027 NEW MEMBERSHIP APPLICATION

Child Information

Primary Parent/Guardian Contact Information

Parent /Guardian Contact Information

Dismisal Process & Authorized Pick Up

Behavioral and Developmental Information

Medical & Allergy Information

Dismisal Plan

Parent Acknowledgments

FINALIZE MEMBERSHIP CARE PLAN

By completing this order, you securing membership for the child above. If you have a second child, please complete another application.

Payment Methods

LEGACY HVA EAST AFTER SCHOOL 2026-2027 NEW MEMBERSHIP APPLICATION

Child Information

Primary Parent/Guardian Contact Information

Parent /Guardian Contact Information

Dismisal Process & Authorized Pick Up

Behavioral and Developmental Information

Medical & Allergy Information

Dismisal Plan

Parent Acknowledgments

FINALIZE MEMBERSHIP CARE PLAN

By completing this order, you securing membership for the child above. If you have a second child, please complete another application. *

Payment Methods

By completing this order, you securing membership for the child above. If you have a second child, please complete another application.