After School

After School

2023
After School Programming

Junior TrainerJunior VetAmbassador Program
Child's Information
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Gender

MaleFemaleOther
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent or Legal Guardian Information
Parent/Legal Guardian*

First NameLast Name
Relation*
Email*
example@example.com
Home Number
Please enter a valid phone number.
Phone Number*
Please enter a valid phone number.
Work Number
Please enter a valid phone number.
Parent/Legal Guardian 2

First NameLast Name
Relation
Email
example@example.com
Phone Number
Please enter a valid phone number.
Contact Information in Case of Emergency
Name*

First NameLast Name
Relation to Child*
Phone Number*
Please enter a valid phone number.
Name

First NameLast Name
Relation to Child
Phone Number
Please enter a valid phone number.
Child's Photo Release
I agree that photos of my child can be taken and used on Frolic social media sites.

YesNo
Any additional Information you would like us to know

Medical, Physical, Etc...
Payment
You may submit your payment on the first day of after school or in advanced over the phone (212) 401-3015
Signature

Clear
Should be Empty:

Child's Information