After School Program Enrollment Form

After School 2026

REGISTRO DE UN NUEVO NINO
for children ages 8-12.
Child's Name = Nombre de Nino*

First NameLast Name = Nombre Apellido
Parent's Phone Number = Teléfono*

Area CodePhone Number
Email*
Parent/Caregiver Name = Nobre de Madre/Padre/Abuella/Hermanos*

First NameLast Name
Grade (2024)*

Grade 3Grade 4Grade 5Grade 6Grade 7
En Español:

___________________________________________

Persona responsable (si es diferente que la madre)

______________________________________

Who do we notify in case of emergency?

Persona a notificar en caso de emergencia:

____________________________________

First Name_Last Name (Nombre_Apellido)

___________________________________

Nombre________________________

Numbero de teléfono_________________________
Please note any known allergies:
Please specify each person, including the name of parents, who has permission to pick up your child at 5:30 from the After School Program.
Authorized Person 1:

First NameLast Name
Phone Number 1:

Area CodePhone Number
Authorized Person 2:

First NameLast Name
Phone Number 2:

Area CodePhone Number
Authorized Person 3:

First NameLast Name
Phone Number 3:

Area CodePhone Number
Authorized Person 4:

First NameLast Name
Phone Number 4:

Area CodePhone Number
Statement of Policy
I have read and understand the Statement of Policy contained here.*

Agree
I give Foundation for New American Art permission to take some photos of my child for fundraising reasons, and for the live stream TV show The Color Wheel*

Agree
Should be Empty:

After School 2026

Statement of Policy