Find the information and download the forms you’ll need to enroll your child in School Age Care.

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Forms

State or county assistance

Families who are working with a state or county agency that helps cover the cost of Child Care expenses must contact their caseworker about the child’s involvement in our program. Parents using state, county or third-party payments must provide a caseworker name, phone number and case number at the time of registration. Only upon receipt of the authorization from the third party, will the child be enrolled.

For County Subsidy, a current “Authorization of Service” must be on file with the Y. Co-payments are due in full by the first of the month, unless payment arrangements are made with the Customer Service Center.

Parents will be held liable for all co-payments and fees not covered by an authorization. An expired authorization or failure to pay co-payments may result in termination of your child’s enrollment. County Claim forms must be signed and returned to the Y within one week of receipt. Failure to provide a signed claim form could result in the parent being liable for full childcare fees.  

Multi-party Billing Agreements

In cases where multiple parties are making payments to a specific childcare account, the Y is not responsible for determining which party has the financial responsibility for specific weeks/days.

The Y is limited on what we can provide for multiple-party billing. Each party must be current with payment in order for child to continue in program. 

A Multiple Party Agreement is required to be completed and signed by both parties. The only payment method offered in multiple-party payment accounts is automatic payment through a credit/debit card. Complete the Electronic Funds Transfer Authorization to set up automatic payment.