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**FEE for ONE STUDENT
The After School Enrichment Program runs from August 29, 2022 - June 09, 2023.
The After School Enrichment Program is open to all students in Kindergarten through 5th grade Students are enrolled on a first-come, first serve basis.
**Select start date and enter Fee Amt
Below you will find links to the 2022-23 Parent Guide, Discipline Policy, and Child Care Laws. Please be sure to read all forms and print the Parent Guide and Discipline Policy for future reference.
Please read the following statements as you will be signing at the bottom of this form that you have read, understand and agree with these statements.
Parent Guide: I have read and fully understand the Parent Guide, payment fees and rules and regulations of the program. I agree that, if dropping from the program, I am required to give a two week PAID notice.
Discipline Policy and Chlid Care Laws: I have read and fully understand the Discipline Policy and the Child Care Laws.
Parental Consent: I hereby give consent for my child to participate in the Pitt County Community Schools and Recreation Summer Enrichment Program. The information provided on this application is correct and complete. While I realize that all precautions will be taken to guard my child from injury, I will not hold the Pitt County Board of Education, Community Schools and Recreation Program or program staff responsible for accidents that may occur. I recognize and understand that participation in recreation activities may necessitate strenuous physical activity and could possibly activate any unrecognized pre-existing medical conditions. I warrant and represent that my child is in good physical health and condition and is able to participate in this program. I agree that the operator may authorize the physician of his/her choice to provide emergency care.
Photo Release: Occasionally we may take photographs of the children in our program. We may use these images in printed publications or on our website. We will not release any personal details or names in our publications or website.
- Please make sure you list all those who will have permission to pick up your child from our program. If someone other than those listed will be picking up your child you will need to fax the information to our office before they will be allowed to do so.
- If any information concerning your child changes, please notify our office in order to keep your information updated.
- Choose the correct status for your child.
Start date must be within 1 week of the Application date. Please speak with a Staff member if a start date outside of 1 week is needed.
Item Amount: $____
+ Additional Fees:
The minimum amount is $1.00.