SYA Bridge Program Registration
Our pilot program will begin on Monday, September 16th and run during after school hours for the duration of the school year! This is a chance for your child(ren) to engage in healthy activities and receive homework support after school! This is our pilot program and a maximum of 50 students will be permitted to participate at this time. FIRST COME FIRST SERVE!

Location: Southampton Elementary School
COST and PAYMENT OPTIONS:
PAY BY MONTH: $120 PER MONTH
PAY SEPT - DEC: $400 Total

Contact us at (631) 283-6873 or syasports@gmail.com for general inquiries
Must submit one form per child.

If you need to PAY only, do not resubmit the form, please go to this link: https://www.paypal.me/syainc

SYA, Inc. is a non profit and fees are collected to support with programming fees.
Email address *
Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Age
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Current Grade *
Teacher Name *
Your answer
What time will your child transition to the after school program? *
What is your child's t-shirt size? (kid sizes listed below) *
Please list/describe any special needs, medical conditions or restrictions that you would like to notify us about. *
Your answer
Please list any allergies that your child has. If none, just write 'no allergies." *
Your answer
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