MacFarlane Park Club Registration - Fall Session 2019
STUDENT's Last Name *
Your answer
STUDENT's First Name *
Your answer
Student's Teacher *
Allergies *
At times, snacks are provided during clubs. Please indicate any allergies your child has or type NONE.
Your answer
Parent/Guardian Name *
Your answer
Primary Phone of Parent/Guardian (xxx-xxx-xxxx) *
Your answer
Email Address of Parent/Guardian *
Your answer
Additional Phone Number(s) of Parent/Guardian (xxx-xxx-xxxx) *
Your answer
Additional Pick-up Person(s) with Phone Number(s) *
Persons NOT listed on this form will NOT be allowed to pick-up your child.
Your answer
Select a club for Monday (10 Mondays) *
2:00-3:00 PM Early Release Mondays; 3:00-4:00 NON-Early Release Mondays
Is your child attending HOST after clubs on Monday? *
Select a club for Tuesdays (11 Tuesdays) *
3:00-4:00 PM
Is your child attending HOST after clubs on Tuesday? *
Select a club for Wednesday (11 Wednesdays) *
3:00-4:00 PM
Is your child attending HOST after clubs on Wednesday? *
Select a club for Thursdays (11 Thursdays) *
3:00-4:00 PM
Is your child attending HOST after clubs on Thursday? *
Select a club for Fridays (11 Fridays) *
3:00-4:00 PM
Is your child attending HOST after clubs on Friday? *
Late Pickup and Late Payment Fee *
Every time my child is picked up 10 minutes late or more there will be a late charge of $10 after the first 10 minutes and $1 per minute after that. For late payments, there will be a fee of $10 for payments received after the payment due date.
Required
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