Before/After School Registration Form
*Complete a separate form for each child*
Student Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Main Contact Phone:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Email:
*
example@example.com
School Attending in September 2026-2027
*
School #3
School #4
School #5
School #6
Middle School
Grade for 2026-2027
*
Pre-K
K
1st
2nd
3rd
4th
5th
6th
7th
8th
Permission to Walk Home
*
Yes
No
Authorized Pick Up Person(s)
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Authorized Pick Up Person(s)
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Authorized Pick Up Person(s)
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Authorized Pick Up Person(s)
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Choose One Option (10% Discount if Registering More than One Student)
*
Enroll my child in BEFORECARE 7:30 AM-Start of School - Non Refundable Registration Fee: $50 - First Month Tuition: $150 - Total Due at Registration : $200
Enroll my child in AFTERCARE 3:00 PM-6:00 PM - Non Refundable Registration Fee: $50 - First Month Tuition: $275 -Total Due at Registration : $325
Enroll my child in BOTH BEFORECARE AND AFTERCARE - Non Refundable Registration Fee: $50 - First Month Tuition: $425 - Total Due at Registration : $475
$200 for 10 Drop in Sessions (Morning and/or After Care)
Monthly Payment Preference (Choose One) Would you like your CREDIT CARD/ACH automatically charged each month?
YES - By choosing YES, you authorize Cliffside Park School District to charge your credit card or checking account monthly. The charge will occur on the 1st of the month, except for the last month of the program.
NO - By choosing NO, you are requesting to have monthly invoices sent to the email above. - Mailed monthly check payments must be received by the 1st of the month.
Submit
Should be Empty: