Beyond the Bell Branch
Ready, Set, Go! Before School Program
LATE ARRIVAL FORM
State legislation governing before school programs for elementary schools funded by After
School Education and Safety Program (ASES) and/or 21st Century Community Learning
Centers (21st CCLC) funding to be open for two hours before the start of the school day. It is
the intent of the state legislation that elementary students attend the full program for at least five
hours per week. In the event that a program has a waiting list of students and families desiring
service, preference must be given to those students who can attend a minimum one hour per
day. However, there are circumstances in which the parent/guardian can have the child arrive
late under one of the following conditions:
A. Attending a parallel program (programs in the school or community such as an early
child care service) as long as an agreement with the parent or guardian exists making
this the child’s enrichment component.
B. Family emergencies (such as a death in the family, catastrophic incidents).
C. Medical appointments.
D. Poor weather condition, fire or earthquake.
E. Other conditions especially in regards to safety, as prescribed by the school, local
district, or local government body.
If your child is unable to arrive one hour before the start of the school day due to one of the
above conditions, please indicate the day, time and reason:
Name of Child:_________________________ Grade :______ Date of Birth:________
Month ________________ Start Date: _________ End Date:_________
Monday Tuesday Wednesday Thursday Friday
In signing below, I request that my child be excused from the program at the specified times. I
understand that neither the program provider nor the Los Angeles Unified School District are
liable for incidents involving my child that occur before his/her late arrival time.
_________________________ ____ _________________ __________________ _______
Parent/Guardian Signature Date School Program Supervisor Date
For additional grant information and/or guidelines please visit www.cde.ca.gov/ls/ba/as