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Part 1: Student Information
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* Indicates required question
Student's Name
*
Your answer
What program are you enrolling your child in:
Before School
Afterschool
Both
Other:
Clear selection
Student ID# ( If you can not locate your child's Student ID# leave it blank)
Your answer
Student Email
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
School Attended
*
Your answer
Primary Language
Your answer
Grade
*
Your answer
Shirt Size
XS
S
M
L
XL
XXL
Clear selection
Home Address
Your answer
Student Ethnicity/Race
Black
White
Hispanic
Asian
Native American
Other
Gender
*
Male
Female
Eye Color
*
Your answer
Hair Color
*
Your answer
Height
*
Your answer
Weight
*
Your answer
How is your child attending school?
Fully In-Person
Fully Virutal
Hybrid
Other:
Clear selection
Does your student speak a language other than English fluently
Yes
No
Clear selection
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