ONE APPLICATION. YOUR CHILD’S SCHOOL.

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Choose your child’s school in the application below. Browsing a school’s information does not select it for you.

Already submitted an application? Contact The Dream Center before submitting another.

2026-27 After School Care Application

After School Care Application

Please fill out all information.

School Name

Child’s first name?

Child’s last name?

What grade is your child in for the upcoming school year

Child's date of birth

Child's first day

Choose the first weekday your child will attend. Your initial payment covers this first service week, even when paid in advance. Weekly tuition is not prorated. Complete parent-paid applications become active after successful payment. Sponsorship applications require approval. Automatic renewals begin on the next enabled billing date for a later service week.

What is the sex of your child?

Child's teacher / homeroom teacher

Is your child proficient in English

Other languages spoken in your home

Which race/ethnicity best describes your child?

What is your street address?

In what city do you live?

Does the child have health insurance?

YES

What is the name of your medical insurance carrier?

What is the medical insurance carrier number?

List any allergies, illnesses, medicines, behaviours, or other important medical issues that we should know about concerning your child. If there are none, write none

Primary Parent/Guardian's Full Name

Primary Parent/Guardian's Cell Number

Primary Parent/Guardian's email address

Secondary Parent Guardian's Full Name

Secondary Parent/Guardian's Cell Number

Emergency Contact Name

Emergency Contact Relationship to Child

Emergency Contact Number

We want to help your child in the best way possible and grant the best experience. Please tell us the way your child communicates. Check all that apply

What, if any, help does you child receive at this time? Check all that apply

What conditions does your child have that are expected to last for a year or more? Check all that apply

Do any of the conditions marked above make it harder for your child to do things that other children can't do?

Who referred you to the program? (PLEASE STATE THE PERSON'S NAME IF APPLICABLE)

Typing your name in the box below constitutes an electronic signature

Additional Information

To support your child, what area of assistance might your child need help in

If there is anyone who is NOT to pick up the child, please list the names.

Other than the child's Parents, who is permitted to pick up the child? List names

How would you like to pay?

Pay one week now — no automatic renewal

Automatic weekly payments — renews until canceled

One-week payments do not renew. For later weeks, use the Weekly Payments link on our website. Choosing this option does not cancel an existing subscription. If you already have auto-pay, contact Dream Center before making another payment or submitting another application.

Nathan B Young | $40 Subscription

$40.00 for each week

Thena Crowder | $60 Subscription

$60.00 for each week

Nathan B. Young — first week only

Price: $40.00

Thena Crowder — first week only

Price: $60.00

No payment items has been selected yet

Discount Code

Apply Coupon

Pay with Card

Has this child previously enrolled in a Dream Center program?

No, this is the child’s first Dream Center enrollment

Yes, and I have the child’s Dream Center Student ID

Yes, but I do not know the Student ID

Dream Center Student ID

DC-

Enter only the six numbers shown after DC- on your child’s ID.