2016-2017 RC After-School Enrollment
Thank you for selecting RCAS as a place for your child to experience a balance of academic and fun!
2016-2017 RC After-School Enrollment
Parent Name *
Your answer
Child's Name (1st Child) *
Your answer
Child's Date of Birth (1st Child) *
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DD
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YYYY
Child's Name (2nd Child)
Your answer
Child's Date of Birth (2nd Child)
MM
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DD
/
YYYY
Program (Select One Please) *
3-Days per Week; Please indicate your day preference. We'll do our best to honor your days. *
Your answer
Dance Class on Friday (Taught by Ms. Kirsten)
Rock Creek After-School LLP has my permission to use my or my child’s photograph to promote the services at Rock Creek After-School. I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use. *
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