Fall 2017 Garden Afterschool Program Registration
This is the registration form for the 2017-2018 school year.

Prior to registering, please read the information and program policies for the program by going to www.gardenofwonders.org and clicking "Garden Afterschool".

By entering your email below, you will receive an email confirmation of your registration.

Email address *
Registration for 2017-2018 School Year - Fall Enrollment
Everyone who registers will be notified of their status (either enrolled or waitlisted) by June 5th, 2017. In the event that the program is full, we will add your child to the waitlist, which is maintained all year long.
Are you registering more than one child for this program today?
Please note! If you are registering more than one child, you will need to fill out one form per child.
Did your child attend the Garden Afterschool Program during the 2016-2017 school year? *
Child's Name (First and Last) *
Your answer
Child's Grade Level - Fall 2017 *
Day(s) of the Week Requested
Please check all that apply below. We will build your schedule based on your request and availability.

If your needs are flexible in terms of your choice of days, please be specific when you give details below.

Please check all that apply. *
Enter flexible schedule details:
Your answer
Does your child have any allergies? *
If yes above, please list your child's allergies:
Your answer
Parent Contact and Emergency Details
Parent 1 Name *
Your answer
Parent 1 Email *
Your answer
Parent 1 Phone *
Your answer
Parent 2 Name (Optional)
Your answer
Parent 2 Email (Optional)
Your answer
Parent 2 Phone (Optional)
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone *
Your answer
Person(s) authorized to pick up child other than parent(s) you listed above
Your answer
Person(s) who may NEVER pick up your child (optional)
Your answer
Authorizations and Agreements
Parent or Guardian Authorization - Medication *
My child may be given non-prescribed medication as indicated on the container. This may include sunscreen or anti-bacterial first aid cream. Prescription medications must be current and a permission slip is required per each medication.
Parent or Guardian Authorization - Medical Assistance *
In an emergency, the program teacher has my permission to call an ambulance, or take my child to any available physician or hospital at my expense to obtain medical treatment.
Garden Afterschool Program Disclaimer *
I understand the School District No. 1, Multnomah County and Abernethy School provides only space for the Garden Afterschool Program. Abernethy School does not supervise the care or provide program staffing or program transportation, and I will not expect Abernethy School to take any responsibility for the care of my child.
Enrollment Terms *
By registering my child in the program, I commit to GAP enrollment for a full term (fall, winter, or spring). I understand that my child will be automatically re-enrolled into the next term for the same schedule unless one month’s notice is given by a parent requesting otherwise.
Payment Terms *
By checking the box below, I agree to the following fee schedule: a) I understand that tuition is due by the 5th day of every month and that a $25.00 late fee will be imposed if tuition has not been paid on the supportabernethy.org website by the 15th of each month; b) I understand that the Garden Afterschool Program closes at 5:30 pm and I am responsible for compensating the Garden Afterschool Program teacher on duty with payment of $1.00 for every minute after 5:35 that I am late; and c) I understand that I may be charged a fee if I remove my child from the program one or more days per week without giving one month's notice.
Cancellation or Schedule Change Terms *
If I remove my child from the program or I change the number of days attending, I agree to give one month's notice. I understand that GAP cannot guarantee a refund for unused days in the event that I remove my child from the program with less than one month’s notice.
Click Submit and scroll to the top of the webpage to find your confirmation.
A copy of your responses will be emailed to the address you provided.
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