2026-2027 Full Time ASEP Registration

2026-2027 Full Time ASEP Registration

ELCA After School Enrichment Program
Questions about this application? Please contact Dawn Miller.

Fill out this form only if you are signing up for full time after school services. You will be billed monthly on your FACTS account for after school. Please fill out one form for each child that needs after school care.

If you only need drop-in care, please do not fill out this form. Simply inform your child's teacher that your child needs to go to after school that day and we will add that day to your FACTS account and it will show on your next monthly bill.
Student Information
Student's Name

First NameLast Name
Grade level for the 26-27 School Year
Parent Information
Parent/Guardian Name

First NameLast Name
Parent Email
example@example.com
Parent Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
What date would you like to begin full time after school services?

MonthDayYear
Date
Terms & Conditions
Terms & Conditions
Review
Please review your registration details as well as the terms and conditions. By signing and submitting this form, you certify that all information is correct and agree to the ELCA After School Enrichment Program (ASEP) terms and conditions.
Signature
Should be Empty:

Student Information