Before and After School Program

Before and After School Program

2022-2023 School Year
I am applying for *

Before School (6:30-7:30 a.m.) After School (3:00-5:30 p.m.) Both
Student's Name *

First Name Last Name
Age *
Grade (22-23 School Year) *
Parent/Guardian Name *

First Name Last Name
Phone Number *
Please enter a valid phone number.
Current School *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Emergency Contacts

Please list names and phone numbers of individuals that are allowed to pick up your child
Name
Phone
Name
Phone
Name
Phone
Before and After School Program will be free of charge for the 2022-2023 School Year

School Choice Deadline is May 1st. Click the link below for application and details.

School Choice Application and Info
Should be Empty:

Emergency Contacts