Enrollment Checklist - Fee Based Ymca Of Silicon Valle

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Enrichment Program:
Enrollment Checklist - fee Based
YMCA of SiliCon VAllEY
Child’s name
Child’s Start Date
After School Site
PlEASE iniTiAl EACh iTEM AfTER CoMPlETinG ThE PACKET
foRM
PAREnT’S iniTiAlS
CoMPlETED (STAff)
Welcome Letter
After School Registration - Fee Based
Admission Agreement - Fee Based
Liability and Indemnity Agreement
Health History/Child Release and Consent Form
Student Behavior Management Procedures
Early Release Policy
After School Parent Agreement
Transportation/Walk Home Release
Emergency Preparedness Kit (optional)
Special Needs Inclusion Intake Form
Participation (Middle School Only)
Family Handbook
ACKnoWlEDGEMEnT AnD RECEiPT
I acknowledge that I have received, read, and sought clarification of any questions I have about the contents of the
After School enrollment packet.
Parent/Guardian Signature
Date
STAff uSE onlY
Date Packet Received:
Received By:
Enrolled Date:
Added to Waitlist (Date):

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