ACS Afterschool Program Registration

ACS Afterschool Programs Registration

All registrations are received and reviewed in a first-come, first-serve basis. Upon filling all open spots, all additional submissions will be added to our waiting list.
Parent/Guardian Information
Name Parent/Guardian 1*

First NameLast Name
E-mail Parent/Guardian 1*
Name Parent/Guardian 2

First NameLast Name
E-mail Parent/Guardian 2
example@example.com
Home phone*

Area CodePhone Number
Cell phone*

Area CodePhone Number
Work phone

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Student(s) Information
1st Child Full Name*

First NameLast Name
Gender*

FemaleMale
Birth Date*

MonthDayYear
School Attending*
Grade Attending*
Does your child have any allergies / Medical Condition(s)?*

YesNo
If yes please list, including any food or drug allergies.
2nd Child Full Name

First NameLast Name
Gender

FemaleMale
Birth Date

MonthDayYear
School Attending
Grade Attending
Does your child have any allergies / Medical Condition(s)?

YesNo
If yes please list, including any food or drug allergies.
Other Infomation
First Date of enrollment*

MonthDayYear
Date
How many days per week would you like to participate?*
Which specific dates would you like to come if joining partial weeks?
AM class / PM class (for TK / K only)
Pick up service from school needed?*

YesNo
Chinese program preferred

CantoneseMandarin
Additional elective courses that you may interested

Writing (3rd Grade or above)Computer CodingMath SquareChessPublic SpeakingDrawing
Comments
Emergency Contacts - Other than Parent/Guardian
Full Name Contact 1*

First NameLast Name
Phone Contact #1*

Area CodePhone Number
Full Name Contact 2*

First NameLast Name
Phone Contact #2*

Area CodePhone Number
All registrations are received and reviewed in a first come, first serve basis. Upon filling all open spots, all additional submissions will be added to our waiting list.
Should be Empty:

ACS Afterschool Programs Registration

Parent/Guardian Information

Student(s) Information

Other Infomation

Emergency Contacts - Other than Parent/Guardian