IN Brentwood-Baldwin-Whitehall Fall 2017 | Page 71

The Y’s school age child care programs participate in the Keystone Stars Quality Initiative program, a state-wide initiative of the Office of Child Development and Early Learning to improve, support and recognize the continuous quality improvement efforts of early learning programs in Pennsylvania. GROW, LEARN, THRIVE Increase self-esteem and self-reliance Build character Improve personal and family relationships Appreciate diversity Develop leadership skills SPENCER FAMILY YMCA / BRENTWOOD SCHOOL DISTRICT BEFORE & AFTER SCHOOL ENRICHMENT REGISTRATION 2017 - 2018 We do not guarantee placement for the fall if registration is received in our office later than July 31, 2017. Child’s Name Date of Birth Gender Grade Level in the Fall Address City State Zip Parent’s Name Parent’s Date of Birth Phone Cell Email Parent Address if Different From Child City State Zip Emergency Contact (Other than Parent or Guardian) Authorized Pick-Up Other than Parent or Guardian) Special Needs Considerations of the child List Allergies that May be Life Threatening Parent Signature Membership: 2 Adult Family with Kids 1 Adult Family with Kids Single Adult $83/month $66/month $54/month Registration: (One-Year Fee) Tuition: For children in grades K-6 EVERYONE IS WELCOME We’re committed to providing quality programs to everyone in the community regardless of their financial limitations. Through our Annual Campaign we’re able to provide assistance based on demonstrated inability to pay, and the Y’s funding capability. All financial assistance information is kept confidential. Applications are available at the Welcome Center of the Y. Our school age care programs are registered with and accept payment from, Child Care Information Services of Allegheny County (CCIS). Serving Brentwood School District students in grades K-6 through our locations at: Elroy Elementary Moore Elementary For more information, please visit the Welcome Center today or contact our Youth Development Director: Annamarie Casciato [email protected] $ ____________ 30.00 $ ____________ $ ____________ Part Time Full Time 1-3 Days Weekly 4-5 Days Weekly After School Care Community Member $235 $310 Prices are Total Monthly Fee Facility Member $205 $240 3:00pm - 6:00pm School Attending _______________________________________________ _ _ _ If part time, please check days that apply M T W Th F Total $ ____________ Initial Payment Information: Cash Check (Payable to Spencer Family Y) Credit (YMCA Business Office will contact you for further details) Use Card on File To No cash, checks, or money orders will be accepted for tuition payments. Draft Information: Payments for standard tuition plans are deducted on the 1st and 15th. CCIS copays are deducted on the 1st day of care each week. Please use the above credit and information for my semi-monthly draft. Do you receive help paying for child care, not including the family? None CCIS CYF YMCA Financial Assistance Other _______________________________________ YMCA OF GREATER PITTSBURGH Brentwood-Baldwin-Whitehall | Fall 2017 | icmags.com 69 YMCA Afterschool provides more than just homework support and a healthy snack or dinner. The Y uses an evidence-based curriculum to create an environment where children can explore, challenge themselves and find comfort in our nurturing approach. HELLO