elk river After-School Program Sign Up
Full Name
*
First Name
Middle Name
Last Name
Grade Level
*
Please Select
5th
6th
7th
8th
9th
10th
11th
12th
for Incoming A.Y. '12-'13
Email
Phone Number
High School
*
Please Select
Elk River High School
Elk River Middle School
Spectrum Middle School
Spectrum High School
Vandenberge Middle School
Salk Middle School
Prairie View Middle School
Rogers Middle School
Rogers High School
Other
Parent's Email
*
example@example.com
Emergency Contact
*
First Name
Last Name
Relationship
*
ex. Father, Mother, etc.
Phone Number Of Person To Contact In Case Of Emergency
*
Please enter a valid phone number.
Please verify that you are human
*
*Please be advised that you will need to present your student ID upon checkin
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