KMS After School Enrollment Form

KMS After School Enrollment Form

Please submit one form per child. The KMS After School program is based on a quarterly fee. Rate varies depending on KMS or NON KMS status beginning at about $300 a month. Registration begins with an application and payment made online by August 1, 2014. After School Care will commence as needed in August and have a weekly rate until first quarter payment is due on August 14, 2014. See website starting on July 18th for the payment schedule. Fees are subject to change. Any questions please contact the After School Program at (415) 821-1434 x26 or Program fee is due on the 14th of the prior month. Payments not made on time are subject to $50 late fee. No refunds.
  • Child's Information

  • Parent 1 Information

  • Policies and Protocol

  • Program Hours, Closures and Late Fee Policy

    The aftercare program runs from 2:15 - 6:00 pm on regularly scheduled school days. If you wish to drop-off your child before program hours, you must obtain prior approval from the Lead After School Teacher, and additional fees may apply. You are responsible for knowing all scheduled days when KMS will be closed, including holidays, conferences, staff development days, etc. Please refer to to see our academic calendar. On these days you are responsible for finding alternative childcare as no staff will be present on those days. The school closes at 6:00 pm. There are no exceptions to the 6:00 pm pick-up time. There is no Extended Care offered beyond this time. The post-6:00 protocol is as follows: • A KMS staff member will stay with your child. In keeping with KMS policy, you will be assessed a $30 late fee for the first ten minutes you are late. This policy is in place to discourage late pick-ups, when all KMS employees are off the clock and otherwise unpaid, and undoubtedly wanting to begin heading home. • Phone numbers provided on this form will be called at 6:05 pm. • If the parent has not arrived by 6:10, the parent will be charged an additional $1 for every minute late thereafter. And late fee incurred must be paid on that same day to the staff member. Failure to do so will result in additional fees. • If the parent has not arrived or called by 6:15 and we have been unable to reach any of your emergency contacts, the police will be called for further assistance.
  • Keeping Us Informed

    If your child will not be attending the program on a regularly scheduled day, please contact the Lead After School Teacher to let him/her know beforehand. All messages should be received prior to 1:30 pm on that same day.
  • For Kids Arriving Via School Bus

    If your child does not arrive on the bus on a regularly scheduled day and prior notice is not given (see above), a staff member will contact the parent(s) via the phone number they have provided.  For this reason, please provide a number where you can be reached during program hours.  If we are unable to reach the parent, it is assumed that the child will not be attending that day, and we will not be held responsible for his/her whereabouts.
  • Permission to Leave

    the following people, other than parents are authorized to pick up my child: (NOTE: they will be asked for valid photo ID). The child will not be released to anyone not listed on the accepted pick-ups list. If anyone else will be picking up your child, you must notify the Lead After School Teacher of this prior to 1:30 pm on that same day.
  • Parental Release Form

    1. I understand that it is the responsibility of every individual and his or her parents or legal guardian to provide for his or her own accident or health coverage while participating in all KMS activities. 2. I authorize the KMS and its adult staff or representatives to consent to any emergency medical treatment and/or hospital care which is rendered to the minor named above, under the supervision of any physician licensed under the California Medical Practices Act. 3. I grant permission for the above-named minor to participate in all After School activities both at and away from the school. 4. I grant permission for photos including the above-named minor to be used for KMS marketing purposes unless otherwise indicated in writing. 5. I understand that my child and I are expected to honor KMS’s After School policies.
  • Release of Liability

    Acknowledgment and Assumption of Risk: My Child and I are aware that there are many risks inherent in the activities offered in connection with the After School Program, which activities may include (but are not limited to): sports, hikes, arts and crafts, dance, and field trips to public parks, museums and various other locations by walking, public and/ or private transportation (including but not limited to buses, ferries, cars). My Child and I understand that some of these risks cannot be eliminated, altered or controlled, and that these risks can be the cause of my Child’s injury, illness or death or damage to my or my Child’s belongings. My Child and I knowingly and freely assume all risks and hazards in these Activities, both known and unknown, whether caused by the action, inaction or negligence of the KMS, its agents, employees, representatives and affiliates (the “Released Parties”), and we assume full responsibility for the participation of my Child in the Activities.
  • Release

    In consideration for my Child being permitted to participate in the After School Program, my Child and I agree not to make a claim against or sue the Released Parties, and my Child and I release and hold harmless the Released Parties for all demands, actions or claims of liability arising out of the negligence or any other act or omission by the Released Parties that causes my Child’s illness, injury, death and/or damage to my or my Child’s belongings as a result of my Child’s participation in the After School Program.
  • Knowing and Voluntary Execution

    I have carefully read this Release of Liability in its entirety, fully understand its terms, and acknowledge that it is a binding and fully enforceable contract between me, my Child and the KMS.

For more information about the After School Program please contact ~ (415) 821-1434 ext. 26