Heritage Park School Age Survey | Heritage Prk Children's Programs

Fall Attendance Survey

Heritage Park Location

Parents Last Name

Parent's First Name

Child's Name

In September I will require the following care for my child(ren). Please include the number of children in each program and note whether you require full time, part time or flex care.

School Age Program - Full Time

School Age Program - Part time/Flex

Part Time

Flex

Withdrawl Option

My Child(ren) will not be attending your program in the fall. (Please write down withdrawl date along with your written notice of withdrawl)

Comments or Concerns?

IF YOU PLAN ON REMOVING YOUR CHILD FOR THE SUMMER MONTHS, RETURNING IN THE FALL, PLEASE INCLUDE THIS IN THE COMMENTS SECTION AND PROVIDE A $30.00 DEPOSIT, IF YOU HAVEN’T ALREADY DONE SO, TO HOLD YOUR SPACE. THIS DEPOSIT WILL BE APPLIED TO YOUR SEPTEMBER FEES AND IS NON-REFUNDABLE IF YOU CHOOSE NOT TO RETURN.

Thanks for submitting!