After School Program Behavior Policy & After School Agreement

Limited enrollment for Spring 2022. Registration Form/1st-5th Grade

This Form must be completed by the Legal Parent or Guardian Prior to Each Semester
After School Program Behavior Policy & After School Agreement

(Please Read and Sign Below)
By Checking the Box below you are agreeing to the Hangar learning center's Behavior Policy and After School Agreement.
How Many Students are you registering?

1 2 3 4
1st-5th Grade Student & Parent Info
Student 1 Name

First Name Last Name
Student 2 Name

First Name Last Name
Student 3 Name

First Name Last Name
Student 4 Name

First Name Last Name
Parent Name

First Name Last Name

Student Information
Student 1 Date of Birth

Month Day Year
Date
Student 2 Date of Birth

Month Day Year
Date
Student 3 Date of Birth

Month Day Year
Date
Student 4 Date of Birth

Month Day Year
Date
Student 1 Gender

Male Female
Student 2 Gender

Male Female
Student 3 Gender

Male Female
Student 4 Gender

Male Female
Student 1 School of Attendance
Student 2 School of Attendance
Student 3 School of Attendance
Student 4 School of Attendance
Student 1 Grade; Teacher's Name
Student 2 Grade; Teacher's Name
Student 3 Grade; Teacher's Name
Student 4 Grade; Teacher's Name
Student 1: List any health conditions/allergies/current medications that we should know about. If there are no conditions we should be aware of, enter “NONE”.
Student 2: List any health conditions/allergies/current medications that we should know about. If there are no conditions we should be aware of, enter “NONE”.
Student 3: List any health conditions/allergies/current medications that we should know about. If there are no conditions we should be aware of, enter “NONE”.
Student 4: List any health conditions/allergies/current medications that we should know about. If there are no conditions we should be aware of, enter “NONE”.

Student 1 - Days you would like your child to attend.

Mondays waitlist Tuesdays waitlist Wednesdays waitlist Thursdays
1st-5th Grade Students

Registration Fee

$50

Due at Signup (Non-Refundable)

The Hangar After School Program

$20 per Hour per Student (2 hour sessions)

*Invoice will be emailed seperately*

Registration Fee for 1 Student

$ 50.00 Quantity

Registration Fee for 2 Students

$ 100.00

Registration Fee for 3 Students

$ 150.00

Registration Fee for 4 Students

$ 200.00

Total

$ 0.00

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Limited enrollment for Spring 2022. Registration Form/1st-5th Grade