Parents’ Time Off Registration Form

    Personal Information
    Parent/Guardian Information
    Emergency Information
    Medical Information
    Please check the following which apply to your child.


    Helpful Information
    Is there a behavior plan in place?
    Payment Information

    The Youth Services Parents’ Time Off program is $25 per evening/day. This fee will increase to $30 on March 1st. Thanks to our sponsors, tuition assistance is available if needed.
    We require financial statements for verification, such as proof of income and/or disability related expenses. Please contact us at or or 214-351-2500 ext. 2273 to be considered.

    Please check before submitting.