24-25 Before and After Care Pre-Enrollment

IMAGINE CHANCELLOR BEFORE CARE & AFTER CARE PRE-ENROLLMENT FORM

Once the pre-enrollment form is filled out, an email for the registration form and payment instructions will be sent. *Note: Once capacity is filled, you will be placed on the wait list.
THIS FORM IS FOR THE 2024-2025 SCHOOL YEAR ONLY!

THE 2025-2026 BEFORE CARE & AFTER CARE PRE-ENROLLMENT FORM WILL BE POSTED ON FRIDAY, AUGUST 1, 2025.
Program:*
Student Information

1st Child:
First Name*
Last Name*
Age*
Grade*
Student Information

2nd Child (if applicable):
First Name
Last Name
Age
Grade
Student Information

3rd Child (if applicable):
First Name
Last Name
Age
Grade
Student Information

4th Child (if applicable):
First Name
Last Name
Age
Grade
Parent/Guardian Information
Full Name*

First NameLast Name
Cell*

Area CodePhone Number
E-mail*
You will be contacted at this email address upon acceptance into the program.
Should be Empty:

IMAGINE CHANCELLOR BEFORE CARE & AFTER CARE PRE-ENROLLMENT FORM