After School

After School Registration Form

August 12th, 2025 - May 22nd, 2026
Please fill all the required fields and we will send you a registration form required by the state to be filled for each child.
Registering for:*

2026-2027 Academic Year2025-2026 Academic Year
1 - Student's Full Name *

First NameLast Name
2 - Student's Date of Birth *

MonthDayYear
Date of Birth
3 - 2025-2026 Grade Level*
4 - Start Date*

MonthDayYear
NOTE: Your start day will be moved to the following day if the registration is received after 12:00 PM.
5 - Select your child's school - Other schools' pickup are subjected to confirmation *
School Name
PARENT INFORMATION
Mother Full Name *

First NameLast Name
Mother Email *
example@example.com
Mother Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Father Full Name *

First NameLast Name
Father Email *
example@example.com
Father Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Home Address *

Street Address

Street Address Line 2

CityState

Zip Code
PAYMENT

Carefully select your option
IMPORTANT INFORMATION
- The first payment will include a non-refundable $80 Annual Resource Fee per family.
- Payment Frequency: Monthly
- The total fee for the program is calculated as Weekly fee × 36 weeks / 10 months, to make payments manageable and consistent from August through May.

Choose Your After School Option Below:*

5 Days / week - WITH Pickup - $95 a week

5 Day Afterschool 2025-2026

$422.00 for the first month then,$342.00 for each month

3 Days / week - WITH Pickup - $75 a week

3 Day Afterschool 2025-2026

$350.00 for the first month then,$270.00 for each month

5 Days / week - NO Pickup - $80 a week

5 Day Afterschool 2025-2026

$368.00 for the first month then,$288.00 for each month

3 Days / week - NO Pickup - $60 a week

3 Day Afterschool 2025-2026

$296.00 for the first month then,$216.00 for each month

Enter coupon

Optional Notes for Pick- Ups:
Please include clear, detailed notes for pick-up, if any.
Select your three day options below:

MondayTuesdayWednesdayThursdayFriday
Select your Per Day option below:

MonthDayYear
Choose the Date to enroll your child for the day.
Enrollment Agreement

Please review and sign
Signature*
Date of Consent*

MonthDayYear
Date
How did you hear about this program*

GoogleFacebookInstagramWhatsAppEmail / GEM NewsletterFriendAttended an event at GEMWalked inBack to School FairReceived postcardRepresentative CalledOther
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After School Registration Form