Holy Cross Lutheran Academy

Childcare Form

Utilize this form when needing to make a change to lunch bunch, extended day or before/aftercare.

Please select the childcare change you need to make:

Remove a selection previously made for the upcoming 2026-27 school year

Make a childcare change for the 2025-26 school year

Parent/Guardian Name(Required)

First Last

Email(Required)

How many students need childcare for the 2026-27 school year?(Required)

How many students previously registered for childcare need a change?(Required)

Student Name(Required)

First Last

Grade(Required)

Please select all childcare options needed for this student for the 2026-27 school year.(Required)

Before Care – $55/month (7:30am – 8:15am)

Lunch Bunch – $400/month (11:30am – 3:40pm)

Lunch Bunch Extended – $600/month (11:30am – 5:30pm)

Please select all childcare options needing to be removed for this student for the 2026-27 school year.(Required)

Before Care – $55/month (7:30am – 8:15am)

Lunch Bunch – $400/month (11:30am – 3:40pm)

Lunch Bunch Extended – $600/month (11:30am – 5:30pm)

Please select all childcare options needed for this student for the 2026-27 school year.(Required)

Before Care – $550/year (7:30am – 7:45am)

After Care – $1950/year (3:40pm – 5:30pm)

Please select all childcare options needing to be removed for this student for the 2026-27 school year.(Required)

Before Care – $550/year (7:30am – 7:45am)

After Care – $1950/year (3:40pm – 5:30pm)

Please select all childcare options needed for this student for the 2026-27 school year.(Required)

After Care – $1950/year (3:40pm – 5:30pm)

Please select all childcare options needing to be removed for this student for the 2026-27 school year.(Required)

After Care – $1950/year (3:40pm – 5:30pm)

Student Name(Required)

First Last

Grade(Required)

Please select all childcare options needed for this student for the 2026-27 school year.(Required)

Before Care – $55/month (7:30am – 8:15am)

Lunch Bunch – $400/month (11:30am – 3:40pm)

Lunch Bunch Extended – $600/month (11:30am – 5:30pm)

Please select all childcare options needing to be removed for this student for the 2026-27 school year.(Required)

Before Care – $55/month (7:30am – 8:15am)

Lunch Bunch – $400/month (11:30am – 3:40pm)

Lunch Bunch Extended – $600/month (11:30am – 5:30pm)

Please select all childcare options needed for this student for the 2026-27 school year.(Required)

Before Care – $550/year (7:30am – 7:45am)

After Care – $1950/year (3:40pm – 5:30pm)

Please select all childcare options needing to be removed for this student for the 2026-27 school year.(Required)

Before Care – $550/year (7:30am – 7:45am)

After Care – $1950/year (3:40pm – 5:30pm)

Please select all childcare options needed for this student for the 2026-27 school year.(Required)

After Care – $1950/year (3:40pm – 5:30pm)

Please select all childcare options needing to be removed for this student for the 2026-27 school year.(Required)

After Care – $1950/year (3:40pm – 5:30pm)

Student Name(Required)

First Last

Grade(Required)

Please select all childcare options needed for this student for the 2026-27 school year.(Required)

Before Care – $55/month (7:30am – 8:15am)

Lunch Bunch – $400/month (11:30am – 3:40pm)

Lunch Bunch Extended – $600/month (11:30am – 5:30pm)

Please select all childcare options needing to be removed for this student for the 2026-27 school year.(Required)

Before Care – $55/month (7:30am – 8:15am)

Lunch Bunch – $400/month (11:30am – 3:40pm)

Lunch Bunch Extended – $600/month (11:30am – 5:30pm)

Please select all childcare options needed for this student for the 2026-27 school year.(Required)

Before Care – $550/year (7:30am – 7:45am)

After Care – $1950/year (3:40pm – 5:30pm)

Please select all childcare options needing to be removed for this student for the 2026-27 school year.(Required)

Before Care – $550/year (7:30am – 7:45am)

After Care – $1950/year (3:40pm – 5:30pm)

Please select all childcare options needed for this student for the 2026-27 school year.(Required)

After Care – $1950/year (3:40pm – 5:30pm)

Please select all childcare options needing to be removed for this student for the 2026-27 school year.(Required)

After Care – $1950/year (3:40pm – 5:30pm)

Student Name(Required)

First Last

Grade(Required)

Please select all childcare options needed for this student for the 2026-27 school year.(Required)

Before Care – $55/month (7:30am – 8:15am)

Lunch Bunch – $400/month (11:30am – 3:40pm)

Lunch Bunch Extended – $600/month (11:30am – 5:30pm)

Please select all childcare options needing to be removed for this student for the 2026-27 school year.(Required)

Before Care – $55/month (7:30am – 8:15am)

Lunch Bunch – $400/month (11:30am – 3:40pm)

Lunch Bunch Extended – $600/month (11:30am – 5:30pm)

Please select all childcare options needed for this student for the 2026-27 school year.(Required)

Before Care – $550/year (7:30am – 7:45am)

After Care – $1950/year (3:40pm – 5:30pm)

Please select all childcare options needing to be removed for this student for the 2026-27 school year.(Required)

Before Care – $550/year (7:30am – 7:45am)

After Care – $1950/year (3:40pm – 5:30pm)

Please select all childcare options needed for this student for the 2026-27 school year.(Required)

After Care – $1950/year (3:40pm – 5:30pm)

Please select all childcare options needing to be removed for this student for the 2026-27 school year.(Required)

After Care – $1950/year (3:40pm – 5:30pm)

Student Name(Required)

First Last

Grade(Required)

Please select all childcare options needed for this student for the 2026-27 school year.(Required)

Before Care – $55/month (7:30am – 8:15am)

Lunch Bunch – $400/month (11:30am – 3:40pm)

Lunch Bunch Extended – $600/month (11:30am – 5:30pm)

Please select all childcare options needing to be removed for this student for the 2026-27 school year.(Required)

Before Care – $55/month (7:30am – 8:15am)

Lunch Bunch – $400/month (11:30am – 3:40pm)

Lunch Bunch Extended – $600/month (11:30am – 5:30pm)

Please select all childcare options needed for this student for the 2026-27 school year.(Required)

Before Care – $550/year (7:30am – 7:45am)

After Care – $1950/year (3:40pm – 5:30pm)

Please select all childcare options needing to be removed for this student for the 2026-27 school year.(Required)

Before Care – $550/year (7:30am – 7:45am)

After Care – $1950/year (3:40pm – 5:30pm)

Please select all childcare options needed for this student for the 2026-27 school year.(Required)

After Care – $1950/year (3:40pm – 5:30pm)

Please select all childcare options needing to be removed for this student for the 2026-27 school year.(Required)

After Care – $1950/year (3:40pm – 5:30pm)

What type of change is needed(Required)

Add a childcare service

Remove a childcare service

Services include: Lunch Bunch, Lunch Bunch Extended, Before Care and After Care

Parent/Guardian Name(Required)

First Last

Email(Required)

Student Name(Required)

First Last

Grade(Required)

Please add…(Required)

Before Care – $52.50/month (7:30am – 8:15am)

Lunch Bunch – $350/month (11:30am – 3:00pm)

Lunch Bunch Extended – $550/month (11:30am – 5:30pm)

Please add…(Required)

Before Care – $52.50/month (7:30am – 8:15am)

After Care – $185/month (3:30pm – 5:30pm)

Please add…(Required)

After Care – $185/month (3:00pm – 5:30pm)

Grade(Required)

Please remove…(Required)

Before Care (7:30am – 8:15am)

Lunch Bunch (11:30am – 3:00pm)

Lunch Bunch Extended (11:30am – 5:30pm)

Please remove…(Required)

Before Care (7:30am – 8:15am)

After Care (3:30pm – 5:30pm)

Please remove…(Required)

After Care (3:00pm – 5:30pm)

Change Effective Date(Required)

EFFECTIVE DATE: Please indicate when you need this change to be made. Child Care selections made during enrollment become effective when enrolling. Changes must be made using this form no later than fifteen days before the first of the month in order to take effect the following month and serves as an electronic signature. ie, If a student will no longer need aftercare starting November 1, notice must be made via this form no later than October 15 in order to not be charged on the next payment. If notice is provided after October 15, changes would be effective on December 1.

I need to make another change(Required)

Yes

What type of Child Care change is needed(Required)

Add a childcare service

Remove a child care service

Services include: Lunch Bunch, Lunch Bunch Extended, Before Care and After Care

Student Name(Required)

First Last

Grade(Required)

Please add…(Required)

Before Care – $52.50/month (7:30am – 8:15am)

Lunch Bunch – $350/month (11:30am – 3:00pm)

Lunch Bunch Extended – $550/month (11:30am – 5:30pm)

Please add…(Required)

Before Care – $52.50/month (7:30am – 8:15am)

After Care – $185/month (3:30pm – 5:30pm)

Please add…(Required)

After Care – $185/month (3:00pm – 5:30pm)

Grade(Required)

Please remove…(Required)

Before Care (7:30am – 8:15am)

Lunch Bunch (11:30am – 3:00pm)

Lunch Bunch Extended (11:30am – 5:30pm)

Please remove…(Required)

Before Care (7:30am – 8:15am)

After Care (3:30pm – 5:30pm)

Please remove…(Required)

After Care (3:00pm – 5:30pm)

Change Effective Date(Required)

I need to make another change(Required)

Yes

What type of change is needed(Required)

Add a childcare service

Remove a child care service

Services include: Lunch Bunch, Lunch Bunch Extended, Before Care and After Care

Student Name(Required)

First Last

Grade(Required)

Please add…(Required)

Before Care – $52.50/month (7:30am – 8:15am)

Lunch Bunch – $350/month (11:30am – 3:00pm)

Lunch Bunch Extended – $550/month (11:30am – 5:30pm)

Please add…(Required)

Before Care – $52.50/month (7:30am – 8:15am)

After Care – $185/month (3:30pm – 5:30pm)

Please add…(Required)

After Care – $185/month (3:00pm – 5:30pm)

Grade(Required)

Please remove…(Required)

Before Care (7:30am – 8:15am)

Lunch Bunch (11:30am – 3:00pm)

Lunch Bunch Extended (11:30am – 5:30pm)

Please remove…(Required)

Before Care (7:30am – 8:15am)

After Care (3:30pm – 5:30pm)

Please remove…(Required)

After Care (3:00pm – 5:30pm)

Change Effective Date(Required)

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