After School Program Registration Form 2026-2027

After School Program Registration Form 2026-2027
Milestone Manor is pleased to offer our specialized, hands-on after school enrichment programs running from October through May!

This year, we are offering three immersive, 28-30 week programs designed to turn your child’s creative passions into real-world technical skills.

Please complete and submit one form per student being enrolled in the After School Program.
Student's Name

First NameLast Name
Age
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Grade
Gender
Please note any known allergies:
Is the child a sibling of a student already registered for one of our after school programs?
Please select the after school program you are registering for (if you are registering for one program on Tuesday and one on Thursday, please select both:
Parent's Name

First NameLast Name
Parent's Phone Number
Format: (000) 000-0000.
Parent's Email
example@example.com
Parent's Name

First NameLast Name
Parent's Phone Number
Format: (000) 000-0000.
Parent's Email
example@example.com
Please specify each person other than the parent/guardian, who has permission to pick up your child from the After School Program.
Authorized Person 1:

First NameLast Name
Phone Number 1:
Format: (000) 000-0000.
Authorized Person 2:

First NameLast Name
Phone Number 2:
Format: (000) 000-0000.
Authorized Person 3:

First NameLast Name
Phone Number 3:
Format: (000) 000-0000.
Authorized Person 4:

First NameLast Name
Phone Number 4:
Format: (000) 000-0000.
How did you hear about the program(s):
If you were referred by someone, please type their name below:
Statement of Fees
- An Enrollment Form is required for all students participating in this program.
- Once we receive your enrollment form, you will be sent your contract, Supply Fee, and monthly fee set up (autpay is an option).
- Supply Fees are due upon receipt. Your spot is not locked in until the supply fee is paid. Please note that contract changes can only be made before the start of the class.
- Delinquent accounts may result in dismissal of student from the After School Program.
- If you decide to no longer participate in the program, you are required to let us know 30 days in advance in written form. Since our programs are all project based, there is no guarantees you will have the projects and materials.
- The After School Program ends promptly at 5:00 p.m. After 5:00 pm, there will be a late fee of $5 every 10 minutes.
Statement of Policy
- Milestone Manor students remaining on campus after 3:00pm will have a 30 minute break where they can eat an extra snack and reset before the after school program.
- Only persons authorized by the parent or guardian may pick up your child from the After School program. Please notify the Executive Director in writing (email will suffice) if anyone other than the personnel listed on this form will pick up your child.
- All students attending the After School Program are required to follow all school and program rules. Behavioral problems will result in parent notification and possible suspension from the program.
- Students with a fever or contagious illness may not participate in the program.
- This program is available for all children, grades K-8th grade.
- After School Programs run from October 6, 2026 – May 27, 2027.
I have read and understand the Statement of Fees and Statement of Policy contained here.
I give Cannon School permission to bill my student's account for the After School Program services indicated on this Enrollment Form, according to the Statement of Fees.
Today's Date

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Should be Empty:

After School Program Registration Form 2026-2027

Statement of Fees

Statement of Policy