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  After Care Payment Instructions

  
  Please scroll and follow the prompts...your name and email first, then the child's name, then the amount from your Invoice.  That's all!  You will receive an email confirming your payment.
  
  Thank you for your continued cooperation and support.
  
• This form is not accepting responses at this time.

  • Please fill in the name and email of the person who is paying here  so we can send you a confirmation of your payment. 
  • First Name REQUIRED Please fill out this field. Please enter valid data.

    Last Name REQUIRED Please fill out this field. Please enter valid data.
  • Your Email for Payment Confirmation REQUIRED Please fill out this field. Please enter an email address.
  • Please list the names of the children who were in AfterCare here 
  • Child's First & Last Name(s) REQUIRED Please fill out this field. Please enter valid data.
  • Date of your Bill Please enter valid data.
  • Enter the TOTAL Amount from your Bill REQUIRED $ Please fill out this field. Please enter a positive decimal.

  Total:

  Submit

  Proceed to Payment