EmailMe Form - 2017-18 Stay and Play - Drop In Form

Stay and Play is a wonderful opportunity for children to stay after school and play with their friends from 12:30 to 1:15pm on Mondays through Thursdays. Children must be potty-trained to participate. Parents may register a child for any days on which the child regularly attends school.

The price for Stay and Play is $5.00 in advance and $10.00 if signing up on the morning of drop in.

All drop ins must be paid by cash or check made out to PAS (send in child's green folder - attn: Stay and Play). Drop in forms for will be accepted until 10:30am on the day they plan to stay.

Please pick up your child promptly at 1:15 pm.
Child's Name 1 *
First Last
Child's Class 1 *
Child's Name 2
First Last
Child's Class 2
Drop in date *
MM / DD / YYYY
Drop in date
MM / DD / YYYY
Drop in date
MM / DD / YYYY
Drop in date
MM / DD / YYYY
Comments
Emergency Contact Information
Please enter the name of the parent or guardian who should be contacted in the case of an emergency.
Emergency Contact Name *
Relationship *
Phone *
### - ### - ####
Emergency Contact Email
By signing your name below, you verify that you are the parent/guardian of the child(ren) listed above.
Parent Signature *
First MI Last
Today's Date *
MM / DD / YYYY
Parent's Email *