Date of Birth
Note: If any of the above information changes, please notify the Endless Fun office immediately.
EMERGENCY AND MEDICAL INFORMATION
List two emergency contacts other than listed above: ( note if this person is coming for pickup,photo ID must be provided otherwise child will not be sent home with them.
1st Contact Person
2nd Contact Person
Please note no prescription medication will be allowed, if child is sick please do not admit to program.
If child shows any symptoms of illness, parent/guardian will be contacted to pick up child from Endless Fun and child will not be allowed to participate in activities planned for the day.
After School Program Rules
Snacks will be provided.
The 2-week program starts every Monday.
Hours of operation are starting from 3pm to 6pm - Strict closure after 3hr. time limit, Monday through Friday (other than holidays). • Parents must pick their child up by the time limit or a late fee of $12.50 will be charged on the credit card starting at the end of your time limit for each 15mints.
Please remember that the Endless Fun After School Program is not a babysitting/child care service. Children are expected to interact with other children. Children are also expected to participate in all activities as instructed by the Endless Fun staff.
Failure to follow the rules can result in your child being expelled from the After School Program.
If a child is expelled from the After School Program, there will be no refund of the registration fee.
Disrespect of the Endless Fun staff, refusal to follow instructions, fighting, bullying of any type, are grounds for immediate dismissal.
The entire registration fee is due prior to the child attending the program. There is no refund for early withdrawal from the program.
Hold Harmless Release
I hereby waive, release, absolve, indemnify, and agree to hold harmless the Endless Fun Inc., its directors, officers, organizers, sponsors, supervisory staff, participants, and any other affiliates; for, from, and against all liability because of any bodily injury, or property damage, known or unknown, which may occur or result from the participation of the named child in any and all activities whether the result of ordinary negligence or for any other cause of Endless Fun Inc. I individually, and as a parent/guardian for my child, have read this release and understood all the terms. I consent to the reproduction, use, and distribution of pictures, videos and sound for promotion and advertising to be used in electronic, print and Internet media. This release is valid for all days the child is present for After School Program at Endless Fun Inc.
2 Week Program Dates:
Start Date (M/D/Y)
End Date (M/D/Y)
School Pick up - $5/day
Daily Program Dates:
No. of Days
Dates: (M/D eg. Sep.1,2..)
School Pick-up info if applicable: Name of School, Address, Contact Info.
Payment e-transfer to: firstname.lastname@example.org
In the message section, include your name, child's name and starting date.
Enrollment will be confirmed via email once payment is received and a spot is available. If no spot is available a full refund will be given via e-transfer.
Signature: Parent/ Guardian
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