Winter/Spring 2025 After School Clubs

Winter/Spring 2025 Art & Game Clubs

Thursdays, 4-5 p.m. Jan. 9 - May 8 (No clubs on Jan. 23, March 20, April 17 or April 24). Hosted at Providence School of Arts.
Child's Name

First NameLast Name
Grade Child Entered in Fall 2024
Child's Phone Number
Format: (000) 000-0000.
Child's Birth Date

MonthDayYear
Child's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Which Club is your student interested in?
In Case of Emergency
Guardian Name

First NameLast Name
Relationship to student
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Guardian Cell phone
Format: (000) 000-0000.
Work phone
Format: (000) 000-0000.
Guardian Email
example@example.com
General Medical History
Allergies? We provide snacks, so this is important. Check all that apply
Please list and explain any allergies
List any ongoing Medical Conditions (asthma, seizures, headaches) that we should be aware of:
Should be Empty:

Winter/Spring 2025 Art & Game Clubs