Aftercare Registration Form

Aftercare Registration Form
All registrations are received and reviewed on a first come, first serve basis. Upon filling all open spots, all additional submissions will be added to our waiting list.
General Information
Student Information *

First Name Last Name Grade
First Name Last Name Grade
First Name Last Name Grade
Parent Information *

First Name Last Name
First Name Last Name
Email *
example@example.com
Phone Number *
Please enter a valid phone number.
Other Adults Approved for Child Pickup

First Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
First Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Child Allergies or Medical Conditions

General Information