Extended Learning/ Afterschool Program

Child's Information

First Name

Last Name

Sex

Birth Date

Grade

Age

Medical Concerns

First Name

Last Name

Sex

Birth Date

Grade

Age

Medical Concerns

First Name

Last Name

Sex

Birth Date

Grade

Age

Medical Concerns

T-Shirt SIze

Parent/ Guardian Contact Information

Relationship to Participants: *

Mother

Father

Guardian

Other Other

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Zip *

Phone

Alternate Phone

Email Address *

Please indicate Days of Participation *

Please indicate pick up location *

Philip Simmons Elementary

Daniel Island School

After School and Extended Learning Schedule (Students can be dropped off to accommodate blended learning schedule)

1:50- 2:30 Pickup from Cainhoy, Philip Simmons, Elevate Learning Project, and Daniel Island School.

3:00 Snack

3:30 Homework

4:00 STEAM Enrichment

Monday - Science

Tuesday - Technology

Wednesday - Engineering

Thursday - Art

Friday - Math, and Movement

Students may attend on Early Release Days and Teacher Workdays at no extra cost.

Registration Fee: $100.00/ Weekly fee: $125.00

Flexible Bi-weekly Fees or Monthly Fees are available

(Extra charges will apply when kids are picked up after 5:30 PM - $5.00 per minute)

Afterschool Program Disclaimer: Afterschool program is for one year (2022 - 2023). Parents who enroll their child(ren) are committing to a school year term. ( Starting the 3rd week of August - last Friday in May ). We are closed on Early Dismissal Days. We follow the Berkeley County School District's School Calendar For more information, please call 843-377-8031.

Payment Information

Please indicate *

Yes - I am new to the program

No - I am returning to the program

Please select an option below. *

	Yearly Registration Fee ($100.00)
	Afterschool Care Fee ($125.00)

Sibling/ Returning Student Discount

Current Total:

$0.00

Name on Card *

Credit Card Type *

Credit Card Number *

Expiration Date (mm/yy) *

Code on the back *

Signature Required below

By completing this form, I am granting Daniel Island Tech-Savvy Kids Club permission to charge my credit card for the amount indicated above. This form is permission for transactions relating to Daniel Island Tech-Savvy Kids Club Afterschool Program 2022 - 2023. All fees are non-refundable. It does not provide authorization for any additional unrelated debits or credits to the account associated with this registration form. By providing the information and submitting this form, my account will be charged for the amount related to all Afterschool fees bi-weekly or monthly for a period of one school term (August 2022 - May 2023). By submitting this form, I acknowledge I am the responsible party and will pay all fees associated with this agreement. I understand additional late fees will be applied to my credit card after the 5:30 PM pick-up time. I understand that I am responsible for payments according to the contract terms if I choose to cancel this agreement. Parents may enroll or re-enroll based on availability. Discounts are available for siblings. *

clear