YMCA at New Field 23-24 Registration Interest Form
Hello Families!
If you are interested in registering for the 23-24 YMCA School Programs please fill out this form.
1 form per child
*Please be mindful that space is limited and registrations will be accepted on a first come first serve basis.

Once we receive your request we will reach out with more information about the program such as, registration instructions. payments, and financial aid/YMCA Scholarships.


If you have any further questions about registration, financial aid, or payments please email our Enrollment Coordinator, Nicole Rodriguez: nrodriguez-jalomo@ymcachicago.org

If you have any questions regarding the programs, please email our Site Director, Kina Miller: kmiller@ymcachicago.com


Sign in to Google to save your progress. Learn more
Email *
Email *
Child's First and Last Name *
Child's DOB *
MM
/
DD
/
YYYY
Child's Grade *
Please indicate which days of the week that your child will need After Care. 
*We ONLY offer 3 or 5 days/wk options.
M
T
W
TH
F
5 Days
3 Days
5 Days
Would you like to register for Before Care?
*We ONLY offer 5 days/wk.
 *
Parent/Guardian's First and Last Name *
Parent/Guardian's Phone # *
Address *
Would you be interested in applying for AFC Financial Aid?
*If you do not qualify for AFC, you can apply for a YMCA Scholarship
 *
Would you be interested in autopayments?
*This is only an option for families who are private paying [not using financial aid or YMCA Scholarship]
 *
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of YMCA of Metropolitan Chicago. Report Abuse
Google Forms