25/26 Afterschool Registration Form

25-26 InspireNOLA Schools 21st CCLC Afterschool Registration Form
ATTENDANCE POLICY

As required by the InspireNOLA Charter Schools funding source, children must attend four (4) days per week. Your child should attend daily to receive the full scope of the academic and enrichment curriculum. If your child has three (3) unexcused absences, he or she will be released from the program and will need to reapply.
Student's Name*

First NameLast Name
Gender*
Date of Birth*

MonthDayYear
Date
Ethnicity*
Currant Grade*
Does your Student have an IEP*
What InspireNOLA school site does your student attend?*
Transportation*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/ Guardian #1*

First NameLast Name
Relationship to student*
Email*
example@example.com
Phone Number *
Please enter a valid phone number.
Alternative Phone Number*
Please enter a valid phone number.
Parent/Guardian #2*

First NameLast Name
Relationship to student*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Alternative Phone Number*
Please enter a valid phone number.
Please list the name and grade level of any siblings attending the program.
Please list and allergies or medical conditions that we should be made aware of.
Special Note for Afterschool Staff
Student Pickup: List any unauthorized persons.
InspireNOLA Charter Schools Consent Form- Please Review
Signature

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25-26 InspireNOLA Schools 21st CCLC Afterschool Registration Form