OLV ASP Online Registration

OLV ASP Online Registration Form

PLEASE READ CAREFULLY: Welcome to the online ASP Registration Form for the 2020/2021 school year! This online form registers your child(ren) for the Preschool and/or K-8 programs and takes the place of ALL paper forms EXCEPT the AOC Release & Indemnification & Medical POA form which will need to be completed on paper(one for each child your are registering) and turned into the school office on or before the first day your child(ren) attends the program. This form can be found linked in the confirmation email you will receive once you submit this registration form. Please complete EACH question and submit your registration at the end. FYI......THIS FORM MUST BE COMPLETED IN ONE SITTING, YOU CAN NOT SAVE AND COMPLETE AT ANOTHER TIME.
Child(ren) Information

Please complete the information below for EACH child your are enrolling in an after school program.

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Home Address*

Street Address

Street Address Line 2

CityState

Zip Code
Parent/Guardian Information

Please enter the following for each parent/guardian.
Parent/Guardian1*

First NameLast Name
P/G1 Cell Number*

Area CodePhone Number
P/G1 Work Number*

Area CodePhone Number
P/G1 E-mail*
Parent/Guardian2 Name*

First NameLast Name
P/G2 Cell Number*

Area CodePhone Number
P/G2 Work Number*

Area CodePhone Number
P/G2 E-mail *
example@example.com
Emergency Contacts

Please enter 3 Emergency Contacts we can call if we can't reach you or other spouse/guardian. DO NOT ENTER YOUR OR YOUR SPOUSE'S INFORMATION!
Emergency Contact1 Name*

First NameLast Name
EC1 Relationship*
EC1 Cell Number*

Area CodePhone Number
Emergency Contact2 Name*

First NameLast Name
EC2 Relationship*
EC2 Cell Number*

Area CodePhone Number
Emergency Contact3 Name*

First NameLast Name
EC3 Relationship*
EC3 Cell Number*

Area CodePhone Number
Authorized Pick Up List

Please list ALL individuals(OTHER THAN YOU/SPOUSE) who can pick up your child(ren).

Authorized Pickup 1
Authorized Pickup Name1*

First NameLast Name
AP1 Cell Number*

Area CodePhone Number
AP1 Relationship*
Add a 2nd Authorized Pickup Person?*

YesNo

Authorized Pickup 2
Authorized Pickup Name2

First NameLast Name
AP2 Cell Number

Area CodePhone Number
AP2 Relationship*
Add a 3rd Authorized Pickup Person?

YesNo

Authorized Pickup 3
Authorized Pickup Name3

First NameLast Name
AP3 Cell Number

Area CodePhone Number
AP3 Relationship*
Add a 4th Authorized Pickup Person?

YesNo

Authorized Pickup 4
Authorized Pickup Name4

First NameLast Name
AP4 Cell Number

Area CodePhone Number
AP4 Relationship*

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Authorizations and Acknowledgements

Please CAREFULLY read and acknowledge your agreement with each statement by typing your first and last name in the box under each item.
1. Emergency Treatment Authorization: In case of an emergency, I authorize Emergency Medical Services (911) to treat, and, if necessary, to transport my child to the nearest hospital emergency room for treatment.*
Parent/Guardian Typed First/Last Name
2. ASP Registration Fee: I authorize OLV to deduct the program registration fee of $25/family on or about August 10th. I understand that payment will electronically deducted through FACTS on or about that date.*
Parent/Guardian Typed First/Last Name
4. ASP Payments: I understand that payments for the ASP will be invoiced through the FACTS Tuition System and will be due on the 10th of the month for the CURRENT month. Any adjustments because of unexpected school closures will be made the following month. Charges will show as "ASP Incidental Expense".*
Parent/Guardian Typed First/Last Name
4. AOC Release/Indemnification/Medical POA: I understand that I must print and complete ONE FORM FOR EACH CHILD I am enrolling in ASP and agree to turn that form into the school office before the first day attending the program. *
Parent/Guardian Typed First/Last Name
5. HANDBOOK ACKNOWLEDGEMENT: I acknowledge I have read and understand the ASP Preschool Handbook and/or K-8 ASP Handbook shown below and agree to abide by the policies set forth.*
Parent/Guardian Typed First/Last Name
Preschool ASP Handbook
6. Agreement to Enroll: By typing my name below, I agree to enroll my child(ren) in the Preschool and/or K-8 ASP Program.*
Parent/Guardian Typed First/Last Name
Preview Form/Make Corrections/Submit

Click the Preview button below to proof your submission. If you find errors, there is a Back button at the bottom which will take you back to the original form and you can change any information needed. Once complete, please to click SUBMIT. NO CHANGES MAY BE MADE AFTER YOU CLICK SUBMIT so please check your submission carefully. You will receive a confirmation email confirming your registration. This email will contain a link for you to print the AOC Indemnity/Medical POA Form.
Should be Empty:

OLV ASP Online Registration Form

Child(ren) Information

Parent/Guardian Information

Emergency Contacts

Authorized Pick Up List

Authorizations and Acknowledgements

Preview Form/Make Corrections/Submit