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Pelham Children s Center School Age Child Care SACC Hutchinson Elementary School 2017-2018 Child s Name Sex M / F circle one Home Address DOB Teacher Grade Please circle the days your child will attend BEFORE SCHOOL PROGRAM 7 30AM-8 20AM Mon Tues Wed Thurs Fri AFTER SCHOOL PROGRAM 3PM-6PM Mon Tues Wed Thurs Fri Parent/Guardian I Name Address Employer Please list the numbers which we can best reach you. Please provide your child with a water resistant sunscreen with an SPF 15 or higher that...
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