Before & After School Interest Form
Interested in doing something fun and engaging after school?
I am interested in
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Before School ($20/wk)
After School ($50/wk)
Both BS & AS ($70/wk)
Half Day Drop-in Only ($120/semester)
Child's Name
*
First Name
Last Name
Grade
*
Parent/Guardian's Name
*
First Name
Last Name
Parent Email
*
example@example.com
Parent Phone
*
-
Area Code
Phone Number
Phone #2 (optional)
-
Area Code
Phone Number
I understand that this is an interest form only and submission does not guarantee acceptance into the program.
*
I Agree
Submit
Should be Empty: