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* 1. Parent name

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* 2. Parent phone number

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* 3. Member name

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* 4. Member Grade

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* 5. Please select the day(s) you need.

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* 6. I understand that if I must cancel services, that I must text 714-360-3628 or send a message on ProCare, 24 hours before day of cancelation to avoid $25 No Call/ No Show fee.

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* 7. I understand that a No Call/ Show will result in a $25 fee per day.

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* 8. I acknowledge that the hours of operation this day are from 7:00am-6:30pm. I also acknowledge that breakfast is from (7:30-8:30am), lunch (11:30-12:30pm) and snack at (3:30).

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