After School Registration Form

After School Registration Form
Loving our Blackness is an after school program that will be held Monday to Thursday. Doors open at 3pm Program is from 4:30-7:30pm. Starting September 29th 2025. Dinner will be provided.

WE WIN's programs are open to all children grades K-8th in the Minneapolis and the surrounding areas.

We will be in our NEW Building located at

2801 S Wayzata Blvd, Minneapolis, MN 55405

(FOR MULTIPLE CHILDREN, PLEASE FILL OUT A SEPARATE REGISTRATION FORM)
Youth's Name *

First NameLast Name
Participant's Age(as of Sep1st)*
Date of Birth*

MonthDayYear
Date
Gender*

MaleFemaleN/A
What grade is your child in (25/26)*
What school is your child enrolled in*
Is your child enrolled in a Minneapolis Public School?*

YesNo, Enrolled in a Private SchoolNo, Enrolled in HomeschoolNo, Another school districtNo, Other
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Email*
example@example.com
Parent/Guardian Phone*
Please enter a valid phone number.
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone*
Please enter a valid phone number.
Does your child have any allergies or dietary restrictions? *

Yes, Please provide details belowNo
Allergies and/or dietary restrictions your child has .*
Please list any medical needs your child may need.*
Authorized Pickup Persons*

Parent/GuardianOther
Authorized Pickup Persons
How did you hear about the WE WIN After School program?
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