Download pdf - 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: _________



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.

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 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!

REGISTER BY MAY 24

2019 Do you need child care this summer? YES NO

Will you be returning in the fall? YES NO