SY 2025-2026 A+ Registration

BEFORE YOU BEGIN

Before you proceed, please note this registration is for

2025-2026 SCHOOL YEAR ONLY.

DUPLICATE registrations may also delay processing so please ensure accuracy and thoroughness when registering.
Current Date for DOB fields

MonthDayYear
Date
Dropbox
Dropbox Name Partition
IMPORTANT YOUR REGISTRATION DOES NOT GUARANTEE ACCEPTANCE.

The A+ Program's Site Coordinator or representative will contact you once your registration is reviewed to let you know enrollment status. Should you have any questions, please contact the A+ Site Coordinator.

Once you have completed your child(ren)'s registration, you will receive an email with a PDF of your registration for your files.

Please note red astericks (*) indicate a required field. If no valid entry for a required field, please put NA.

After your child is registered and accepted into the program, a secure link for signing up for automatic tuition payments will be sent to all accepted families in mid-July 2025.

TIP To save your registration to complete later, click on the Save button at the bottom. From the pop-up, click on "Skip Create an Account" at the bottom and you'll be able to enter your email to be sent a link to continue later.

Proof of Eligibility
Eligibility Check*

I am self-employedI am employedI am a studentI am under First-to-Work
Parents or legal guardians are required to demonstrate eligibility for the A+ Program. This process verifies that all participating families meet the specified eligibility requirements.

Please upload one of the following based on what you selected in the Eligibility Check section:
- Employed: A recent paystub, with the incomeamounts crossed out or blacked out, OR a letter from your employer on official company letterhead. Active Duty orders also valid for military personnel
- Self-Employed: General Excise Tax License, Copy of the previous year’s tax returns, or printed business check (Please VOID check)
- Student: Copy of School Schedule for the upcoming semester. Classes must overlap or occur during afterschool hours of School Dismissal to 5:30pm
- First-to-Work: Form DHS 728
If you are listing two parents/guardians on the registration form, please make sure to also upload their information in the below Upload section. You can select multiple files to upload or click on it again to upload another file.
File Eligibility Upload*

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SY 24-25 A+/Before Care Registration

DOE Schools Only
Child 2: Full Name

C2 First NameC2 Last Name
Child 2: Gender
Child 2: Date of Birth*

MonthDayYear
Date
Child 2: Age
Child 2: Grade Entering*
C2: Has the child attended this A+ site program before?*

NoYes
Child 2: Program(s) Requesting*

A+Before Care
Have another child (3) to register?*

YesNo

Child 3: Full Name*

C3 First NameC3 Last Name
Child 3: Gender*
Child 3: Date of Birth*

MonthDayYear
Date
Child 3: Age
Child 3: Grade Entering*
C3: Has the child attended this A+ site program before?*

NoYes
Child 3: Program(s) Requesting*

A+Before Care

Other Children in Household:
Child 1 in Household: Name
First and Last Name
Child 1 in Household: School
Child 1 in Household: Grade
Child 2 in Household: Name
First and Last Name
Child 2 in Household: School
Child 2 in Household: Grade
Child 3 in Household: Name
First and Last Name
Child 3 in Household: School
Child 3 in Household: Grade
Each child being registered needs an Emergency Form. Fill out another Emergency Form?*

NoYes

If my child needs to be taken to an emergency facility, he/she will be taken to the nearest one. I give my consent for school authorities to take appropriate action for the safety and welfare of my child. Please sign below:*

Clear

Authorizations

I authorize only the following people to pick-up my child or to be called in case of an emergency (in addition to parents/guardians)
Contact 1*

Contact 1 First NameContact 1 Last Name
Contact 1 Relationship to Child*
Contact 1 Driver's License #
Contact 1 Home Phone/Cell*
Please enter a valid phone number.
Contact 1 Work Phone
Please enter a valid phone number.
Contact 2

Contact 2 First NameContact 2 Last Name
Contact 2 Relationship to Child
Contact 2 Driver's License #
Contact 2 Home Phone/Cell
Please enter a valid phone number.
Contact 2 Work Phone
Please enter a valid phone number.
Contact 3

Contact 3 First NameContact 3 Last Name
Contact 3 Relationship to Child
Contact 3 Driver's License #
Contact 3 Home Phone/Cell
Please enter a valid phone number.
Contact 3 Work Phone
Please enter a valid phone number.
Contact 4

Contact 4 First NameContact 4 Last Name
Contact 4 Relationship to Child
Contact 4 Driver's License #
Contact 4 Home Phone/Cell
Please enter a valid phone number.
Contact 4 Work Phone
Please enter a valid phone number.

PARENT / GUARDIAN CONSENT FORM

I hereby give my child permission to attend and participate in the activities conducted by Kama‘aina Kids' A+, Summer A+, Before Care, and Holiday Care programs for the school year noted above.

I hereby agree that, if Kama‘aina Kids staff is unable to contact me or one of the persons listed as emergency contact, I hereby consent that if my child exhibits signs of illness or injury, that at the discretion of the Kama‘aina Kids supervisor on duty, my child may be taken to the nearest medical facility and be given any examination/treatment that is deemed necessary by the personnel of the medical facility, and if permissible by medical facility, subsequently released to Kama‘aina Kids supervisor or staff-in-charge.

I hereby authorize Kama‘aina Kids to use my child’s name and video or photograph at any time and in any manner in connection with its advertising, publicity, and public relations programs including its website, social media, and other digital platforms. The video/photo may only be used by Kama‘aina Kids. No further claims will be made by me.

DISCIPLINE POLICY

Discipline is used to assure the safety and well-being of all program participants. All children are expected to respect themselves, other people and their property. If a child is not following the guidelines of Kama‘aina Kids staff consistent with these expectations, then child will take a “time out” from the activity at the staff member’s discretion. A child with continued behavior problems will be sent to the Kama‘aina Kids’ Program Site Coordinator who may contact the parents for the purpose of suspending or removing the child from the program. Kama‘aina Kids reserves the right to refuse any child’s future participation in its programs, if it is deemed appropriate to maintain the safety of all program participants.

I hereby authorize Kama‘aina Kids to exercise these discipline policies regarding my child.

CONFIDENTIALITY

I understand that any information in this registration packet will not be disclosed to persons other than Kama‘aina Kids staff unless the parents or guardians of the child grant written permission for the disclosure or an emergency arises.
Parent/Guardian Consent Form-Discipline Policy-Confidentiality
Parent/Guardian 1 Signature*

Clear
Date*

MonthDayYear
Date
Parent/Guardian 1 Email*
example@example.com
Parent/Guardian 2 Signature

Clear
Date

MonthDayYear
Date
Parent/Guardian 2 Email
example@example.com
Home Address*

Home Street Address

Home Street Address Line 2

Home CityHome State / Province

Home Postal / Zip Code
Mailing Address*

Mailing Street Address

Mailing Street Address Line 2

Mailing CityMailing State / Province

Mailing Postal / Zip Code
Email registration to*
example@example.com

Parent/Guardian’s Responsibilities and Agreements
1. My child(ren) is not allowed to come and go freely from the A+ Program site.
2. My child(ren) must sign-in each day and I (or authorized adult) must sign him/her out each day.
3. My child(ren) will be released only to the adult(s) listed on the registration form.
4. I must maintain communication with the Site Coordinator/Group Leader about my child(ren) and keep him/her informed of pertinent changes.
5. I must notify the Site Coordinator/Group Leader of daily departure changes.
6. I must contact the A+ Program when my child(ren) will be absent on any of his/her scheduled days of attendance, regardless of whether he/she was absent from school. I realize this is for my child(ren)’s protection.
7. If a medical emergency arises, the A+ Program will first attempt to contact me. If I cannot be reached, the A+ Program will attempt to contact adults authorized by me in case of emergency, and that if no authorized adults can be reached, appropriate treatment will be secured at the nearest medical facility. If a major illness or injury is involved, my child(ren) will be transported by ambulance to a designated site and/or physician and I am financially responsible for any medical care or transportation incurred on my child(ren)’s behalf.
8. The A+ Program will operate from close of school to 5:30 p.m. each school day or at another designated time as determined by the site. The program will not operate during school vacations, state holidays, Teacher Institute Day, and school half-days.
9. Transportation to and from the A+ Program will not be provided. If my child(ren) attends an A+ Program at a school other than his/her regular school, I must make transportation arrangements and assume responsibility for getting my child(ren) to the other school.
10. It is my responsaibility to see that my child(ren) is picked up by the designated closing time.
11. If my child(ren) is having problems in the program, a conference will be arranged between myself, the staff, and the Site Coordinator.
12. The A+ Program reserves the right to terminate A+ Program services if it is determined that placement is unsatisfactory.
13. If weather or other emergency forces the closing of regular school, the A+ Program will also be closed.
14. If my work/school schedule changes, I must notify the A+ Site Coordinator about the changes.
15. I am aware and authorize that my child(ren) may participate in physical development/coordination activities during A+.
16. I understand that my child(ren) will be given an option of alternative activities if they choose not to participate in physical development/coordination activities during A+.
Parent/Guardian’s Billing and Fee Agreements
1. I am responsible for monthly A+ Program tuition.
2. I shall pay the monthly tuition when it is due or it must be postmarked before the first school day of each month.
3. I must not send payments to school with my child(ren), but must bring or mail them to the A+ Program at the school.
4. The monthly tuition I pay for my child(ren) is a flat rate, and it does not depend on the number of days my child(ren) actually attends the program.
5. The A+ Program will make no refunds once tuition is paid for the month even if my child(ren) has attended only part of the month, e.g., even for one day.
6. I must pay a $25.00 service charge (cash or money order) for checks that I write to the program that are returned by the bank because of insufficient funds.
7. I understand that the monthly A+ Program tuition is due on or before the first school day of each month. I shall pay a $5.00 late charge per family for each school day a payment is overdue. If I do not pay the monthly tuition within the first five (5) A+ Program days of the month, it will result in my child(ren)’s immediate termination from the A+ Program on the sixth (6th) A+ Program day.
8. Failure to pay any outstanding fees by the end of the month shall result in my child(ren)’s termination from the program.
9. My child(ren) may re-enroll if I pay all outstanding fees, and a penalty fee of $25 for reinstatement. If I have more than one child enrolled in the A+ Program, my family is penalized a flat reinstatement fee of $25.
10. I will arrange for another authorized adult to pick up my child(ren) if the adult responsible for my child(ren)’s pick-up is to be late. If no other arrangements can be made, I will make every effort to call the school to notify A+ staff of my expected tardiness.
11. If my child(ren) is picked up late, I will pay a $15 fee for the first 5 minutes and a $1.00 per minute late fee per child for every minute thereafter beyond the closing time.
Please INITIAL that you have read, understand, and agree with each bulleted item noted above.*

Clear
Please SIGN that you understand and agree to abide by the above parents responsibilities and billing procedures. I understand and agree that my failure to do so may result in termination of my child(ren)'s enrollment in the A+ Program.*

Clear
Subsidy Application for Financial Support

Must meet all eligible requirements
I would like to apply for subsidized monthly tuition. I give my permission to the Hawaii State Department of Education (HIDOE) and its contracted private providers to use information in HIDOE files or files from other state agencies to verify my child’s eligibility for subsidized monthly A+ fees.*

NoYes

The State Department of Human services (DHS) provides funding for subsidies to cover the cost of the monthly Afterschool A+ program fee to assist families in need. The DHS has adjusted the eligibility schedule, increasing the maximum income eligibility levels. Therefore, families who previously exceeded the income eligibility may now possibly qualify for this subsidy, which will cover the full monthly program fee.

If your family qualifies according to the A+ Income Eligibility Table below, download and submit your application to your A+ program to receive the subsidy that will cover the full monthly program fee. If you are not eligible for subsidies through the DHS A+ Subsidized Monthly Fee, you may still apply for subsidies through the Child Care Connections Hawaiʻi!

Income Eligibility Calculator
Upload Required Supporting Documentation*

Cancelof
I have attached the required supporting documentation. (Refer to List of Acceptable Income Documentation for the After-School Plus (A+) Program shown above.*

Yes
TIP You can save your progress if you need more time to prepare your required documents. To save your registration to complete later, click on the Save button at the bottom. From the pop-up, click on "Skip Create an Account" at the bottom and you'll be able to enter your email to be sent a link to continue later.

Monthly Income of Parent/Legal Guardian Living in Household
Application for each household if there is joint custody.

If you are currently receiving financial assistance from Department of Human Services (FTW) Program, you do NOT have to complete Household Member section below, however, you must provide the A+ Program with Form DHS 728 from the FTW Program office.

To figure/convert to monthly income: Weekly income x 4.33, Income every 2 weeks x 2.15, Twice a month income x 2. List the names of all children and parent/legal guardian living in your household, including yourself and the child(ren) being registered.

For Household Members section below, please list the names of all children and parent/legal guardian living in your household. Include yourself and the children you are registering.
Total number of household members*
Household Member 1: Full Name *
Household Member 1: GROSS Monthly Earnings (before deductions)*
Enter 0, if not applicable
Household Member 1: Monthly Welfare, Alimony, Child Support & Social Security*
Enter 0, if not applicable
Household Member 1: Monthly Pension or Retirement Payments*
Enter 0, if not applicable
Household Member 1: Any OTHER Monthly Income*
Enter 0, if not applicable
Household Member 2: Full Name *
Household Member 2: GROSS Monthly Earnings (before deductions)*
Enter 0, if not applicable
Household Member 2: Monthly Welfare, Alimony, Child Support & Social Security*
Enter 0, if not applicable
Household Member 2: Monthly Pension or Retirement Payments*
Enter 0, if not applicable
Household Member 2: Any OTHER Monthly Income*
Enter 0, if not applicable
Household Member 3: Full Name *
Household Member 3: GROSS Monthly Earnings (before deductions)*
Enter 0, if not applicable
Household Member 3: Monthly Welfare, Alimony, Child Support & Social Security*
Enter 0, if not applicable
Household Member 3: Monthly Pension or Retirement Payments*
Enter 0, if not applicable
Household Member 3: Any OTHER Monthly Income*
Enter 0, if not applicable
Household Member 4: Full Name *
Household Member 4: GROSS Monthly Earnings (before deductions)*
Enter 0, if not applicable
Household Member 4: Monthly Welfare, Alimony, Child Support & Social Security*
Enter 0, if not applicable
Household Member 4: Monthly Pension or Retirement Payments*
Enter 0, if not applicable
Household Member 4: Any OTHER Monthly Income*
Enter 0, if not applicable
Household Member 5: Full Name *
Household Member 5: GROSS Monthly Earnings (before deductions)*
Enter 0, if not applicable
Household Member 5: Monthly Welfare, Alimony, Child Support & Social Security*
Enter 0, if not applicable
Household Member 5: Monthly Pension or Retirement Payments*
Enter 0, if not applicable
Household Member 5: Any OTHER Monthly Income*
Enter 0, if not applicable
Household Member 6: Full Name *
Household Member 6: GROSS Monthly Earnings (before deductions)*
Enter 0, if not applicable
Household Member 6: Monthly Welfare, Alimony, Child Support & Social Security*
Enter 0, if not applicable
Household Member 6: Monthly Pension or Retirement Payments*
Enter 0, if not applicable
Household Member 6: Any OTHER Monthly Income*
Enter 0, if not applicable
Gross Monthly Earnings TTL
Monthly Welfare TTL
Monthly Pension TTL
Monthly Other TTL
Zero Income? You must explain how your living expenses are being met
Parent/Legal Guardian*

Clear
Full Name*

First NameLast Name
Date*

MonthDayYear
Date
Home Phone*
Please enter a valid phone number.
Work Phone
Please enter a valid phone number.

IMPORTANT YOUR REGISTRATION DOES NOT GUARANTEE ACCEPTANCE.

The A+ Program Site Coordinator or representative will contact you once your registration is reviewed to confirm enrollment status. Should you have any questions, please contact the A+ Site Coordinator.

For a listing of A+ Site Coordinator phone numbers, please visit here.

Click on the Submit button below to confirm your registration.

Do not leave this page until the submisson is complete and you see a Mahalo confirmation.

After submission, please check your email for your completed PDF registration packet to receive the link to download the DOE A+ Parent Handbook.
Should be Empty:

BEFORE YOU BEGIN

Proof of Eligibility

Start Online Registration

SY 24-25 A+/Before Care Registration

Parent/Legal Guardian 1

Parent/Legal Guardian 2

Emergency Form

Other Children in Household:

Emergency Form

Other Children in Household:

Emergency Form

Other Children in Household:

Authorizations

Parent/Guardian Consent Form-Discipline Policy-Confidentiality

Subsidy Application for Financial Support

Income Eligibility Calculator

Monthly Income of Parent/Legal Guardian Living in Household

Do not leave this page until the submisson is complete and you see a Mahalo confirmation.