After-School Care Registration

We would like to take this opportunity to welcome you and your children to the After-School Care (ASC) here at Indiana School for the Deaf.

The goal of ASC is to provide a quality program that is safe, fun, and affordable. Our program offers age-appropriate activities under the supervision of a competent, trustworthy, caring, and qualified staff that understands and meets the needs of the children in our care.

Student's Name

Grade

Parent/Guardian's Name

Relationship to Student

Text Number

Student's Teacher(s) Name

Emergency Contact Name and Relationship

Emergency Contact Text Number

Urgent Medical Information/Allergy (if applicable)

ASC Payment Plan

Orange Rate Plan

Black Rate Plan

I understand that After School Care policies have been developed to ensure the safety and well-being of all children attending our program. I have read the ASC Handbook and understand the program policies and procedures. I have discussed the rules or the program with my child. I understand that by signing below I acknowledge understanding and indicate intent to follow the policies of ASC.

Parent/Guardian Signature

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ASC Contacts

Student Affairs

Administrative Assistant

Jeanny Wooten

ECE/Elementary
Secretary

Scott Tilson

Middle/High School
Secretary

After-School Care Registration

ASC Contacts

Jeanny Wooten

Scott Tilson

Melissa Hess