Late Stay Registration Form

Late Stay Registration Form

Late Stay is Currently Full, Complete this form For Late Stay Waiting List
Child's Full Name

First NameLast Name
Child's Age
Child's DOB

MonthDayYear
Date
Grade entering Sept '26
Parent Name

First NameLast Name
Parent Phone Number
Format: (000) 000-0000.
Parent Email Address
example@example.com
Dismissal Arrangements
Please list the other families in the Carpool
Any allergies or important information to note?
The After Camp Program will begin on the First Day of Camp, Wed. July 1.

There is no After Camp on the following dates

July 2, 17 Tammuz

July 22, Erev Tisha B'av

August 19 the last day of CTC
Signature
Should be Empty: