EmailMe Form - SCHOOL CLOSING CAMP SURVEY

Student Name *

First Last

Do you need our Schools Out Camp to be open while schools are Closed due to COVID-19
Please Select One Option *

Yes, I need care for my child while schools are closed as I WORK OUTSIDE THE HOME

Yes, I would like care for my child while schools are closed as I WORK FROM HOME

No, I do NOT need care for my child while schools are closed

Days Care is Needed for next 2 weeks
Current After School Program Students:
up to 2 days: Regular Tuition,
3 days: $109 &
4 or 5 days: $149

Non After School Program Students:
1 day $45, 3 days $129 or 4-5 days $159 *

Name *

First Last

What is the EARLIEST you need us to OPEN our Schools Out Camp for you to work?

What is the LATEST you need us to CLOSE our Schools Out Camp for you to work?

Questions or Comments

Relationship *

Phone *

### - ### - ####

Email *