After-School Program Registration
Student Information
Full Name
Grade
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
Date of Birth
Parent/Guardian Information
Name
Phone Number
Email Address
Program Selection
Choose Program
Art Club
Sports
Music Lessons
STEM
Other
Medical/Allergy Information
Details
Emergency Contact (if different)
Name
Phone Number