After School 2024-25 Registration

Active After School 2024-25 Registration

Child's Name(Required)
Birth Date(Required)
Age as of August 20, 2024(Required)
Grade entering Fall 2024(Required)
Primary Parent/ Caregiver Name(Required)
Home Address(Required)
Secondary Caregiver Name
Secondary Caregiver Address
Emergency Contact Address(Required)

List all other adults who are authorized to take the child from the center:

Name
Name
Name
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Camper Medical Information

Please Select All of The Following Conditions/Illnesses That Your Child Has Had:
Address(Required)
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This is a statement of verification that I have been informed that child care licensing/ child maltreatment investigators and/or law enforcement may possibly interview my child for the purpose of determining licensing compliance or for investigative purposes. This is accordance with Minimum Licensing Requirements: DCCEDE/ Child Care Licensing Unit: 200.201.4
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The discipline policy of the Fayetteville Athletic Club, Kids Fit Fun FACtory will be that any time a child's behavior jeopardizes the safety of him/herself, others or is acting in a disruptive manner, the child will be removed from the class or program. The Kids FACtory uses "timeout" to encourage good behavior. A child who has been given a "timeout" will be taken out of the group/class participation and must sit alone quietly under staff supervision for 1 minute for each year of age. After the 2nd offense, another timeout will be given. Following a 3rd offense, the child will be sent home for the remainder of the day. The parents and child will need to schedule a conference with the Director to discuss the issue. Continuous or more serious behavior issues may result in suspension/ pending termination from the Kid's Fit Fun FACtory program. I understand and agree to comply with the Discipline Policy.
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We will be taking pictures throughout the year to capture the action and adventure of our Kids FACtory programs. I hereby grant permission to Fayetteville Athletic Club to use photographs and/or video of my child(ren) taken during FAC programs, in publications, news releases, online, and in other communications related to the Kid FACtory programs.
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The Registration fee and first week of After School fees must be paid to register your child(ren) for the FAC After School Program. The balance will be billed the Friday prior to each week of After School. This balance must be paid by a credit card or bank account on file with FAC. Payments must be received for your camper to attend After School. Non-payment by the required due dates will result in relinquishing the camper's space in the program. FAC Junior Membership are required for each child to receive the Member discount for our After School program. Changes or cancellation requests must be received a minimum of 2 weeks prior to the start of After School and must be made in writing to the Director. FAC member discounts will be voided and additional charges will occur if the FAC Junior membership is canceled at any time during the program duration. A $25 returned payment fee will be applied to any returned payments. Fayetteville Athletic Club accepts, Visa, Master Card, Discover, American Express, bank drafts and checks. I agree to abide by the Billing policy that has been presented.
Credit card type(Required)
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