JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
2018 April Vacation Week Programs Registration
Registration for April Vacation Week Programs should be submitted by Friday, April 13th at 12:00PM.
Confirmation of enrollment will be sent once program minimums have been met. We recognize that vacation week care is time sensitive. As a result, updates will be sent throughout the enrollment period.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Student's Last Name
*
Your answer
Student's First Name
*
Your answer
Grade
*
K
1
2
3
4
5
6
7
8
Parent/Guardian Name
*
Your answer
Address
*
Your answer
Home Phone Number
*
Your answer
Cell Phone Number
*
Your answer
Medical/Allergy Information
*
Please list any allergies, medical conditions and/or other accommodations necessary to ensure your student's safety and full participation while in our care. If there are no special concerns, please type "NONE".
Your answer
Does your student require an Epi-Pen?
*
Yes
No
Emergency Contact Name
*
Please provide the name of an emergency contact if we are unable to reach a parent/guardian.
Your answer
Emergency Contact Phone Number
*
Your answer
Authorized Pick-ups
*
Please list any individuals you authorize to pick up your student after his/her enrichment class. If no one else has permission to dismiss your student, please type "NO ONE".
Your answer
Parent/Guardian Permission
*
Please initial below to indicate that you have read and agree to the terms and conditions of enrollment as explained in the brochure and to give permission for your student to participate in the Office of Family & Community Engagement's Enrichment Programs.
Your answer
Media Release
*
Do you give the Office of Family & Community Engagement permission to photograph your student and to publish photos and/or original student work in any print or digital format including social media platforms?
Yes
No
April Vacation Week Care Options
Half Day Vacation Week Care students must be enrolled in a Vacation Week Enrichment Class.
Full Day Vacation Week Care (Tuesday-Friday)
Half Day Vacation Week Care (Tuesday-Friday)
Clear selection
April Vacation Week Enrichment Classes
Sports Mania (Grades K-2) (12:00pm-3:00pm, Tuesday-Friday)
System 4 (8:30am-11:30am, Tuesday-Friday)
AM Care Options
Please select a drop off time.
7:30AM Drop Off
8:00AM Drop Off
8:30AM Drop Off
Clear selection
PM Care Options
Please select a pick up time.
3:30PM Pick Up
4:30PM Pick Up
5:30PM Pick Up
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Hanover Public Schools.
Report Abuse
Forms
