Summer Child Care Program is for children ages 5-12 currently attending elementary school (five year-olds must have completed kindergarten) Please talk with the director if you have an incoming kindergartener who will need child care over the summer. Child #1 Name: Shirt Size: Youth ________ Adult Size: _________ Child #2 Name: Shirt Size: Youth ________ Adult Size: _________ Child #3 Name: Shirt Size: Youth ________ Adult Size: _________ Parent/Guardian signature: Date: Southwest Washington Child Care Consortium S u m m e r Chi ld C ar e E n r o l lme n t Enrollment is based on a first-come, first-served basis, and signed and completed forms should be returned to [email protected] no later than Friday, May 24, 2019. For a hard copy, please contact your Center Director. Contact us for more information: (360) 750-7501 www.esd112.org/swccc Summer Care Contract: This contract is for 2019 summer child care. Families must contract for a minimum of 3 days, up to 5 days per week, with a regular and consistent schedule. Summer Care begins on the first day of summer break through the last day of summer break, per your school district calendar. Select a minimum of 3 days, up to 5 days that you will need care. If you select less than 3 days, you will still be charged for 3 days. Monday Tuesday Wednesday Thursday Friday List the weeks you will NOT need care: (In order to avoid charges for these days, we must receive your vacation schedule by May 24, 2019.) Fees: • Contracted days: $41/day (minimum 3 days / week) • Additional and drop-in days will be charged at a rate of $46 per day, subject to availability. • All families will need to pay a summer fee of $150 in order to reserve your spot. Partial scholarships may be available to families receiving DSHS subsidies. The Summer fee is non-refundable aﬅer the first day of the summer program. Contract Chan�es: Do you need to cancel or change your child care dates? No problem! There is a $25 contract change fee, and you must give the Center Director a two-week notice prior to any changes. I have reviewed the SWCCC Summer Contracted rates and payment policies. I am contracting for the number of days listed above and agree to pay the weekly contracted rate whether or not my child attends. I understand payment is due monthly, no later than the 15th of the month. All accounts with a past due balance after the 15th will be charged a $15 late fee and services may be discontinued. SWCCC requires a two-week notice for contract changes including discontinuation of care. Center Name: Parent Name: Choose Your Own Adventure! REGISTER BY MAY 24 2019 Do you need child care this summer? YES NO Will you be returning in the fall? YES NO

Choose Your Own Adventure! 2019 - ESD 112

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Page 1: Choose Your Own Adventure! 2019 - ESD 112

Summer Child Care Program is for children ages 5-12 currently attending elementary school(five year-olds must have completed kindergarten)Please talk with the director if you have an incoming kindergartener who will need child care over the summer.

Child #1 Name: Shirt Size: Youth ________ Adult Size: _________

Child #2 Name: Shirt Size: Youth ________ Adult Size: _________

Child #3 Name: Shirt Size: Youth ________ Adult Size: _________

Parent/Guardian signature: Date:

Southwest WashingtonChild Care Consortium

Summer Child Care Enrollment

Enrollment is based on a first-come, first-served basis, and signed and completed forms should be returned to [email protected] no later than Friday, May 24, 2019. For a hard copy, please contact your Center Director.

Summer Care Contract:This contract is for 2019 summer child care. Families must contract for a minimum of 3 days, up to 5 days per week, with a regular and consistent schedule. Summer Care begins on the first day of summer break through the last day of summer break, per your school district calendar.

Select a minimum of 3 days, up to 5 days that you will need care. If you select less than 3 days, you will still be charged for 3 days.

Monday Tuesday Wednesday Thursday Friday

List the weeks you will NOT need care: (In order to avoid charges for these days, we must receive your vacation schedule by May 24, 2019.)

Fees:• Contracted days: $41/day (minimum 3 days / week) • Additional and drop-in days will be charged at a rate of $46 per day, subject to availability.• All families will need to pay a summer fee of $150 in order to reserve your spot. Partial

scholarships may be available to families receiving DSHS subsidies. The Summer fee is non-refundable after the first day of the summer program.

Contract Chan�es:Do you need to cancel or change your child care dates? No problem! There is a $25 contract change fee, and you must give the Center Director a two-week notice prior to any changes.

I have reviewed the SWCCC Summer Contracted rates and payment policies. I am contracting for the number of days listed above and agree to pay the weekly contracted rate whether or not my child attends. I understand payment is due monthly, no later than the 15th of the month. All accounts with a past due balance after the 15th will be charged a $15 late fee and services may be discontinued. SWCCC requires a two-week notice for contract changes including discontinuation of care.

Center Name:Parent Name:

Choose Your Own Adventure!

2019 Do you need child care this summer? YES NO

Will you be returning in the fall? YES NO