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Contact Info:

Tina Whitt, Director
Northern Elementary
3600 Cincinnati Pike
Georgetown, Kentucky 40324
502-868-5007 ext. 2105
Fax 502-863-6654
tina.whitt@scott.kyschools.us

 

Northern's STARS Program

After School Program

 

A school registration form must be completed prior to registration for the Northern STARS Program. Priority to admittance will be given on a first come first serve basis. You may be put on a waiting list, depending on the number of children currently enrolled in the program.

 

Registration and Tuition Agreement:

I understand a non-refundable $25.00 registration fee is due upon registering for Northern STARS Program. I also understand each month's tuition as outlined in the handbook is due on the first school day of each month. I agree to make payments on time and if I am late, I will be subject to a late fee(s) and risk my child being removed from the program. Plus by signing below I agree that my child can watch any G or PG movie shown by Northern’s STARS Program.  Finally, I understand by signing below I have read, understand and agree to all terms in the Northern’s STARS program handbook. 

 

Medical Emergency Transportation

I give permission to Northern Elementary School to transport my child to Georgetown Community Hospital in case of a medical emergency which will require professional medical attention. This decision can and will be made at the discretion of the Northern Elementary principal, staff and/or Northern STARS Program staff.

 

Child’s Name __________________________________________

Date of Birth ___________________________________________

Parent/Guardian’s Name (please print) ______________________

Parent/Guardian’s Signature ______________________________

Phone Number ________________________________________

Cell _________________________________________________

Email Address _____________________@__________._______

Primary Physician Name ________________________________

Primary Physician Number_______________________________

 

This form must be completed at time of registration.

You must allow 24 hours before your child can attend.

 

Office Use Only:

Registration Payment Method ________   Check Number _________     

Date_________   Grade _________     Homeroom Teacher _______________   

Snow Day Release ___________