OFFSITE AFTER SCHOOL 2024/25 Registration/Payment Form

OFFSITE After School Registration Form & Payment

After School 2024/25
STUDENT'S INFORMATION

Please fill in all required fields
Student's Name

First NameLast Name
Student's Birth Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Students Grade
School they attend
Will a sibling be joining them in class?
SIBLING INFORMATION

Please fill in all required fields
Sibling's Name

First NameLast Name
Sibling's Birth Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Students Grade
PARENT/GUARDIAN INFORMATION

You must fill out all sections below
Parent/Guardian Name

First NameLast Name
Main Phone Number
Cell phone preferred Format: (000) 000-0000.
Parent Email
example@example.com
Medical Information

Please fill in all required fields
Please list all ALLERGIES and or any other health/non-health related information you think we should know about your child.
The more information you can provide regarding any additional needs your child may have, the better are able to support them in the classroom.