Child care & AFTER SCHOOL Registration The Afterschool program has a registration of fee $35.00 and a weekly fee of $70.00 per child. Discount for each additional child of $10.00. Payment can be made via credit card, cash, or check. Please make all checks payable to Maranatha Ministries. Please complete one form per child. Feel free to contact us if you have any questions or concerns. Please enable JavaScript in your browser to complete this form.Child's Information - Step 1 of 4STUDENTS FULL NAME *FirstLastDATE OF BIRTH *MM123456789101112/DD12345678910111213141516171819202122232425262728293031/YYYY20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920GRADE LEVEL *Kindergarden1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th GradeWHAT SCHOOL DOES YOUR CHILD CURRENTLY ATTEND? *ContinueEmail *PARENT / GUARDIAN FULL NAME *FirstLastADDRESS *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePHONE NUMBER *EMERGENCY CONTACT NAME *FirstLastEMERGENCY CONTACT NUMBERIN ADDITION TO THE ABOVE INFORMATION, THE FOLLOWING PERSONS MAY/MAY NOT PICK UP MY CHILD:Please specify who "CAN" & "CAN NOT" pick up your child. PreviousContinueSINCE WE WILL BE SERVING AN AFTERNOON SNACK AND HOSTING OUTDOOR ACTIVITIES, PLEASE LIST ANY MEDICAL CONCERNS OR ALLERGIES THAT YOUR STUDENT HAS. *Please answer "NONE" if allergies are NOT presentACKNOWLEDGEMENT *I AGREEI have read and understand the information concerning the after school program and agree to the stated guidelines of participation. I agree to pay the weekly tuition fee for each week hereafter. I understand that my child will not be given any medication (including aspirin and cough drops) during program hours unless authorized to do so by the parent. In case of medical emergencies, I hereby authorize the MMI staff to administer minor first aid procedures to my child if needed. I understand that MMI, the pastor, staff and/or volunteers are not liable for accidents and injuries incurred while at the center. I have read and understand the guidelines and procedures concerning tuition payments and discipline. I also agree to pick up my child by 5:00pm Monday through Friday at the site when the program is in session.PreviousContinueHow would you like to pay?Please choose a form of paymentPayment *Credit CardCashCheckRegistration Payment *Price: $ 35.00Stripe Credit Card *CardName on CardCash / Check PaymentBe sure to bring the $35 registration fee with you on your next visit. Please make all checks out to Maranatha Free Church.Captcha * What does 5 + 5 = PreviousNameSIGN UP
