Prairie Grove School District Paw Prints After School Care Registration Form
Dear Parents/Guardian,
Thank you for expressing your interest in Prairie Grove School District's Paw Prints After-School Program for the 2020-2021 school year. If after reading the after school care Parent/Student Handbook, if you have any questions, please feel free to contact the Paw Prints Program Director, at (479) 846-4211 or paw.prints@pgtigers.org
Email *
I _______________ am enrolling my child _____________in the Prairie Grove School District's Paw Prints After-School Program for the 2020-2021 school year. *
My child will be attending on all days noted: *
Required
Child's Name *
Age/Grade *
Parent's Name *
Parents Contact Information (between 3:00-6:00) *
Persons Authorized to pick up my child: Please all list names and relationship. *
Known Allergies *
Parents are: *
Required
Please list any custody issues:
Mother's Full Name *
Contact Phone: *
Mailing Address: *
Physical Address: (if different)
Name of Employer
Work Address:
Work Phone:
Occupation:
Hours:
Father's Full Name: *
Contact Phone *
Mailing Address: *
Physical Address: (if different)
Name of Employer:
Work Address:
Work Phone:
Occupation:
Hours:
EMERGENCY CONTACTS: Please list name, phone, and relationship to child. *
EMERGENCY CONTACTS: Please list name, phone, and relationship to child. *
Submit
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