2020-21 Before and After Care Enrollment Form
Due Date: August 1st, 2020.
Please complete (1) online questionnaire form per student attending for individual medical information.
Students may not attend either program until the enrollment form and registration fees are received.
Email address *
Student Last Name *
Student First Name *
Student Grade and Homeroom *
Gender *
Primary Home Address - House #/Street/City/State/Zip *
Primary Phone *
Secondary Address - House #/Street/City/State/Zip
Secondary Phone
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