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
Date
Students Grade*
School they attend *
YESNO
SIBLING INFORMATION

Please fill in all required fields
Sibling's Name *

First NameLast Name
Sibling's Birth Date*

MonthDayYear
Date
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.

After School Options - Please check the upper left hand corner of the class of your chose then check that the quantity is correct, check your total before making payment please*