SYLVANIA SCHOOLS

Pay-to-Participate Form for Extracurricular Activities and Clubs
Please note: you must fill out a separate form for each student

Student Name 		ID# 		  School 	Student Grade	 Year		 Activity/CIub 				
Fee Schedule for Extracurricular Activities and Clubs

NOTE: Fee invoices will be added to MySchoolBucks after rosters are finalized. Please go to myschoolbucks.com to make payments.

Yearly Fee Schedule per student for High School:	First activity	$50.00	
	Second activity	$35.00	
	Third activity	$ 0	
Yearly Fee Schedule per student for Jr. High School:	First activity	$25.00	
	Second activity	$15.00	
	Third activity	$ 0	

Family cap per year per family for extracurricular activities and clubs:	$150.00

In order to help facilitate the family cap, please list all students in your family who are currently in High School and/or Junior High School (regardless of whether they will participate in extracurricular activities this year):

Student's Last Name	Student's First Name	Grade	School of Attendance	

				

For Office Use Only:

Amount Paid	

Credit Card, Check or Cash 	
Cir (VISA, MC, Discover, AMEX), Check # 	

Date Paid 	

Received by 	

Treasurer Office 6/2025