SikhiCool Summer School

Safe Space

An AfterSchool Program

March 2020 - June 2020

Enrollment Form

FREE ADMISSION
[Please fill separate form for each child]
Guardian Information:
Mother's Name/ Primary Guardian #1

First Name Last Name
E-mail *
Cell Phone Number *
Father's Name/ Primary Guardian #2

First Name Last Name
E-mail *
example@example.com
Cell Phone Number *
Primary Guardian #1 Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Primary Guardian #2 Address same as #1 *

Yes No
Primary Guardian #2 Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Children & Youth Information
Participant #1 First and Last Name *
Date of Birth *

Month Day Year
Participant #1 Address same as: *

Guardian #1 Guardian #2
Participant #2 First and Last Name *
Date of Birth *

Month Day Year
Participant #2 Address same as: *

Guardian #1 Guardian #2
Participant #3 First and Last Name *
Date of Birth *

Month Day Year
Participant #3 Address same as: *

Guardian #1 Guardian #2
Note: In order to be eligible for participation in SikhiCool Summer School, there needs to be at least 4 weeks of attendance from each participant.
Parent Signature *

Use mouse like a pen to sign in this box. Clear
Should be Empty:

Guardian Information: