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Lebanon Borough
School District

Before & After Care Registration Form

Welcome to the Lebanon Borough School Family! We look forward to having your child join us. Please take a moment to fill out our student registration information below.

Student Information

Enrollment Options

Please choose the following options:
*If you are enrolling your child in both the a.m. and p.m. programs at the rate of $450.00 per month, payment is due with registration and on the first day of each month, October through June. There is a 10% discount to the siblings of any student registered.
**If you would like your child to attend the before/after-care program on a part-time basis, you may purchase a flex-pass for 10 sessions of your choosing at the rate of $125.00 per pass.

Concerns or Special Needs

Please check any existing conditions:

Parent/Guardian Information

Emergency Contacts/Authorized Pick Up

Authorized Pick Up (Must be 18 years or older):
By entering your name below, you are indicating your acceptance to all conditions as described in the before/after care handbook. You understand that the initial tuition is due with the registration form and all subsequent payments are due on the first of each month. You understand that we will provide a snack daily to your child unless written notice is given. All children must adhere to the Lebanon Borough Code of Conduct. Only listed parents and authorized contacts may sign a child out of the program. Late fees will apply according to the schedule in the handbook for unpaid tuition or late pick up.