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Student Information
I am interested in registering for the After Care program. Upon registration, I understand an account will be setup and a registration fee of $50 per student will be billed to my account.
Yes
Student's First Name
Student's Last Name
Grade and Teacher
After Care Information
I will be using the After Care program for the following:
occasionally
on a regular basis
Please indicate all days of the week that apply.
Yes
Monday
Yes
Tuesday
Yes
Wednesday
Yes
Thursday
Yes
Friday
Yes
I will be using the After Care program during the sport's season
Yes
Adults and/or coaches authorized to pick up and sign my child out of After Care Program. (We realize you may not know your winter/spring coaches. When that information becomes available or information changes, please update the office.)
First Name
Last Name
#1
First Name
Last Name
#2
First Name
Last Name
#3
First Name
Last Name
#4
First Name
Last Name
Other Information
The After Care program will use the Emergency Medical Authorization information supplied on the Back-to-School form.
Contact Information
First Name
*
Last Name
*
Phone Number
*
Email Address for billing statements
*