HPA Afterschool Student Application
We are so excited to have your child participate in the after school program. We had such a great time over the summer and look forward to fall programing. Please complete the entire application. If your child participated during the summer, simply put his/her name and update any information that may have changed over summer.
Email address *
Child's Full Name *
Your answer
Prefer to be called (Nickname)
Your answer
Gender
Date of Birth
MM
/
DD
/
YYYY
Address
Your answer
Does this child have allergies of any kind? *
If yes, please list.
Your answer
T-Shirt Size
Are you connected to:
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