ASEDP Registration 2019-2020
Please complete this form to register your child for Oak Grove Elementary's After School Extended Day Program
Child's First Name *
Your answer
Child's Last Name *
Your answer
Grade *
Allergies *
Your answer
2nd Child's Name
Your answer
Grade
Allergies
Your answer
3rd Child's Name
Your answer
Grade
Allergies
Your answer
4th Child's Name
Your answer
Allergies
Your answer
Grade
Name: Parent Contact #1 *
Your answer
email address *
Your answer
Work Phone Number: Parent Contact #1 *
Your answer
Cell Phone Number: Parent Contact #1 *
Your answer
Name: Parent Contact #2
Your answer
Work Phone Number: Parent Contact: #2
Your answer
Cell Phone Number: Parent Contact #2
Your answer
Additional Authorized Pick Up #1 *
Your answer
Cell Phone Number *
Your answer
Additional Authorized Pick Up #2
Your answer
Cell Phone Number
Your answer
Additional Authorized Pick-Up #3
Your answer
Full Time or Emergency Drop In *
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