PS 11 Programs Interim Afterschool 2015
5:00 pickup (K only)
6:00 pickup (K only)
Please check below if your child is allowed to go swimming. Swimming will NOT be offered to K students
My child has permission to swim.
(A $5 handling fee will be charged to all paypal and credit card transactions. Payment may also be made via cash or check in person or via Chase QuickPay.)
Credit card in person
Cash or check in person
I agree to pick up my child at PS 11 at the above designated time. By submitting this form and entering my name in the box below I agree to enroll my child in the Interim Program. A separate emergency/contact form must be completed and on file.
When you submit this form, you will be directed to Paypal. If you wish to pay another way (cash, check, credit card, etc.), just close the window. Payment must be received prior to attendance.
Do Not Fill This Out