2024-2025 School Year Registration
Important Enrollment Information:
SOI enrollment & site placement is based on a first come, first serve basis.
Due to the high volume of e-mails received during the first few days of registration, there may be a delay in response.
Families will be notified of their child's placement sometime in Spring. A non refundable annual $50 registration fee/per family is due upon submission. Current families can pay the registration fee, as done during the school year. New families, the SOI team will be in touch to set up payment options. Monthly tuition payments will be due on the first day of each month.
CHILD'S NAME : (Last, First)
CHILD'S PREFERRED NAME:
DOB: (mm/dd/yyyy)
Child resides with:
Please select
Parent/ Guardian 1
Parent/Guardian 2
Both
Please select
School:
Please select
Eagle
Elsmere
Glenmont
Hamagrael
Slingerlands
Please select
Grade entering in Fall 2024:
Please select
K
1st
2nd
3rd
4th
5th
Please select
Gender:
Please select
Male
Female
Non-binary
Prefer not to disclose
Please select
1. PARENT-GUARDIAN NAME:
Relationship to child:
Please select
Mother
Father
Legal Guardian
Please select
CELL PHONE :
Cell Provider:
Home Street Address:
City:
State:
Zip Code:
Email:
Confirm E-mail Address:
Employer/ Phone #:
2. PARENT-GUARDIAN NAME:
Relationship to child:
Please select
Mother
Father
Legal Guardian
Please select
CELL PHONE:
Cell Provider:
Home Street Address:
City:
State:
Zip Code:
Email:
Confirm E-mail Address:
Employer/ Phone #:
In case of emergency, list at least 2 people (16 years - old or older) to be contacted if neither parent can be reached & will also be authorized for pick-up:
1. EMERGENCY CONTACT NAME:
Relationship to Child:
Please select
Grandparent
Sibling
Aunt/Uncle
Family Friend
Sitter
Guardian
Other
Please select
CELL PHONE:
Home Street Address:
City:
State:
Zip Code:
2. EMERGENCY CONTACT NAME:
Relationship to Child:
Please select
Grandparent
Sibling
Aunt/Uncle
Family Friend
Sitter
Guardian
Other
Please select
CELL PHONE:
Home Street Address:
City:
State:
Zip Code:
If applicable, please list your child's special health care needs:
My child DOES NOT have special health care needs.
My child HAS special health care needs. (Please list in the box provided) I am aware that all OCFS required medical paperwork must be up to date & valid. I am aware that all EMERGENCY medication brought to program must match the physician’s paperwork, be labeled with my child's name in the original box/ including pharmacy label & is not expired. I am aware that all medication & paperwork must be submitted/complete for my child to begin program.
My child requires custody paperwork. I understand up to date paperwork must be submitted to soi@schoolsoutinc.org prior to starting program.
EMERGENCY MEDICAL PERMISSION:
Thereby authorize School's Out, Inc. in an emergency, to grant consent to any physician deemed appropriate to conduct the required tests & provide necessary treatment/care to the above named child, if parent/guardian #1 or parent/guardian #2 cannot be reached.
I give the above Emergency Medical Permission for my child.
PHYSICIAN/MEDICAL SERVICE:
PHYSICIAN/MEDICAL SERVICE PHONE #:
TRANSPORTATION PERMISSION:
I give permission to School’s Out, Inc. to transport my child(ren) to and from daily program for the Enrichment Center & for transportation on Half-day Programs. School’s Out, Inc. has contracted with Bethlehem Central School Transportation Department to provide daily bussing to our Enrichment Center at 239 Delaware Avenue Delmar, NY.
SUNSCREEN/INSECT REPELLENT PERMISSION:
I give permission for School’s Out, Inc. to administer the sunscreen and/or insect repellent I provide for my child while attending the School’s Out Program if my child cannot apply it. It will be my responsibility to supply a sunscreen lotion and/or insect repellent and to bring it to the program site with their name on it.
ACKNOWLEDGEMENT FORM FOR PICK-UP:
I acknowledge that the pickup time for my child enrolled in the School's Out program is 6:00 p.m. I agree to pick up my child from the program by 6:00 p.m. closing time. If I am late, the charge will be $1.00 per minute after 6:00 p.m.
I acknowledge that all information given is current & accurate. I agree to abide by the policies & procedures of School's Out, Inc. This authorization is valid through June 2025, unless revoked in writing.
Program Choice:
Please select
AM & PM Program (5 days)
AM Program (5 days)
PM Program (5 days)
Please select
Signature:
Clear
SUBMIT FORM
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