ST. CLARE BEFORE & AFTER SCHOOL CARE

1807 SW FREEMAN ST.

PORTLAND, OR 97219

503-244-8747

STCLAREBASC@ARACNET.COM

CHILD(REN)’S NAME:____________________________________

PARENT’S NAME:_______________________________________

I HAVE READ THE ST. CLARE BEFORE & AFTER SCHOOL PARENT POLICIES AND PROCEDURES FOR 2007-2008.

I UNDERSTAND AND AGREE TO ABIDE BY THE

POLICIES AND RULES STATED.

SIGNATURE: _________________________________________

DATE: ______________________