Study Hall Registration 20152016
Grades 68 Study Hall is an After School Program that runs MondayFriday 3:305:30 pm. It provides students the opportunity for a quiet place to do homework under the supervision of one of our Middle School teachers. If interested, please fill out the form below. Though we allow dropins, if we do not have a consistent attendance of students in Study Hall, it will be discontinued.
Student’s Name ______________________________ Advisory/Homeroom ___________________ FALL (P lease check the days desired) Monday Tuesday Wednesday Thursday Friday Session 1 1 2 3 4 5 September 1Nov. 20 day/week days/week days/week days/week days/week Tuition
$210
$385
$520
$650
$730
WINTER (P lease check the days desired) Monday Tuesday Wednesday Thursday Friday November 23March 4
Session 2
1 day/week
2 days/week
3 days/week
4 days/week
5 days/week
Tuition
$210
$385
$520
$650
$730
SPRING (P lease check the days desired) Monday Tuesday Wednesday Thursday Friday
March 7June 3
Session 3
1 day/week
2 days/week
3 days/week
4 days/week
5 days/week
Tuition
$210
$385
$520
$650
$730
Study Hall Registration 20152016
Parents/Guardians __________________ Home Phone Number __________________ Parent 1 Work # ____________ Cell # ______________ Email ______________________ Parent 2 Work # ____________ Cell # ______________ Email ______________________ Emergency Contact when a parent/guardian is unavailable Name __________________ Relationship ____________ Best Phone # _________________ Medical Information Primary Care Physician ______________________________ Phone _____________________ Pertinent information on any health conditions including physical, psychiatric or behavioral: __________________________________________________________________________________ ______________________________________________________________________ ____________________________________________________________________________ Allergies: ____________________________________________________________________ The following individuals have permission to pick up my child ____________________________________________________________________________ Name Relationship Best Phone # ____________________________________________________________________________ Name Relationship Best Phone # Terms and Conditions Please note that all payments are nonrefundable. If McLean is closed for any reason, there will be no Study Hall. An additional charge of $5.00 per day will be billed for those students remaining in the program from 5:30 pm6:00 pm. McLean reserves the right to charge a late pickup fee of $2.00 per minute for pickup after 6:00 pm on the McLean clock. The dropin rate is $20/day and is billed monthly. Please direct all questions to the After School and SummerEdge Office. at 240.395.0690 or
[email protected] Parent/Guardian Signature _______________________________ Date ______________