Date *

MM

DD

YYYY

Before and After Care Child's Name *

First Name

Last Name

Child's Date of Birth *

MM

DD

YYYY

Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Or Daily Use (Check All That Apply)

Each daily use equals $38 billed monthly. A minimum of two uses per week is required. (Minimum fee $76 per month)

Before School, Monday

Before School, Tuesday

Before School, Wednesday

Before School, Thursday

Before School, Friday

After School, Monday

After School, Tuesday

After School, Wednesday

After School, Thursday

After School, Friday

Enrollment Fee *

An enrollment fee of $55 is due at the time of registration. Parents have the option to pay with cash or check or be billed through BrightWheel

Cash or Check

Bill me through BrightWheel

I have two or more children enrolled at Pathfinder Kids and am eligible for a discount

Yes

No

I am a member of Pathfinder Church and am eligible for a discount

Yes

No

Agreement *

I have received a digital copy of Pathfinder Kids Parent Handbook https://docs.google.com/document/d/1K_NXpX1eHb0IVETueIn0aVA88IGKzVCB1iml162JT6w/edit

Yes

I understand the disciplinary procedures *

Understood

BrightWheel

Pathfinder Kids used BrightWheel to check in/check out; forms, communication, billing, and more. It is my responsibility to download and attach to Pathfinder Kids.

Understood

Certification *

Checking the form below is considered my digital signature and will be used to establish this contract with Pathfinder Kids. I declare that I acknowledge and agree to the Pathfinder Kids parent handbook. My child and I will follow the policies and procedures contained therein while my child is in attendance at Pathfinder Kids.

Yes