Preschool Extended Child Care Registration Form printable pdf download

Preschool & Extended Child Care

Registration Form

Child’s Name:

School:

Parent / Guardian Name:

Start Date:

Check the programs you are registering for. Please refer to the child care guide for current fees:

PRESCHOOL PLUS FULL DAY

 Full-Day –7am to 7pm, Monday – Friday includes Preschool (choose below)

 3/4 yrs old AM, Monday-Friday

 4/5 yrs old AM, Monday-Friday

 4/5 yrs old PM, Monday-Friday

Fee: $595 per month (This package includes a YMCA family membership)

PRESCHOOL - ONLY

3/4 yrs old:  9am to 12noon, Monday-Friday

4/5 yrs old:  9am to 12noon, Monday-Friday

 1pm to 4pm, Monday-Friday

Fee: $325 per month plus $4.00 per hour for additional hours

EXTENDED CHILD CARE

 Hourly - $4.00 per hour, billed by the quarter hour

Preschool Drop Off Times - To keep disruption to a minimum during preschool programs we ask that parents

make all drop off for AM preschool by 9:05am and by 1:05pm for PM preschool. If you are unable to drop off by

the listed times you may take your child to Extended Child Care, at no additional charge.

Swimming Activities - Parents should know that at times during the Preschool or Extended Child Care programs

children will be swimming in the YMCA swimming pool, under the supervision of YMCA lifeguards.

The YMCA Campus Walking Plan – Parents should know that as a certified child care program we must share

with parents how we move kids around the campus, since we use public sidewalks. Groups of children will walk to

and from the YMCA Main Facility (522 West Sixth St.) and the Hoffbuhr House (219 N Oakdale). They shall be

supervised by a minimum of two adults and the YMCA adult to child ratio will be maintained at all times. Adults will

carry a first aid kit, roster, and children’s contact information while traveling. When leaving the YMCA property the

group will turn right following the sidewalk around the building to Oakdale, turning left on sidewalks only. An adult

shall remain in any motor vehicles driveways until all children have safely passed. Return trips will be made in

reverse order.

Please select payment processing option:

 Electronic Automated Payment: Charges will be processed on the first business day of the month.

This includes all late fees, additional days, etc. Authorization Form must also be completed. Annual

registration fee is $30.

 Monthly Payment: Fees can be made by check, money order, credit card or cash and will be accepted

at the YMCA only (payments cannot be accepted at off-site locations). Annual registration fee is $60.

Preschool Extended Child Care Registration Form