Teacher Workday/School Holiday

Your Name*
First Last
Email*
Phone*
Are you a Jumpstart Member?*
Additional Authorized Pickup Adult*
First Last
Teacher Workday Care*
Price:
Member Care Price*
Price:
Number of Children*
An additional $15 daily fee per child will be added to your weekly tuition
Date*
Child Name*
Child Name(s)*
Child Age*
Child Age(s)*
Allergies we should be aware of:
Please designate child that has the allergy.
Medical conditions or medicine that will need to be administered:
Please designate the child and his or her required medicine (with dosage information).
Emergency Contact:*
First Last
Emergency Phone*
Total
$0.00

Description

Jump Start is open: Monday – Friday: 7:00 am – 6:00 pm (during District 5’s Teacher workdays)

*Please send lunch with your child*