After School Program Application

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All spots are filled at this time.

All applications submitted are for our waitlist.

Student Name (Last Name, FirstName). Please list ALL students that are applying. *

Grade student(s) currently attending. Select the grade for the 2023-24 school year. *

Required

Parent/Guardian Name *

Parent/Guardian Phone *

Please format area code and then number. Ex: 123-456-7890

Parent/Guardian Email *

What activities, if any, is your student currently engaged in afterschool? Select all that apply. *

Sports/Cheer

Club/BullsTV

Tutoring

Extra Innings

Other

None

Required

If involved in a sport/club, which sport/club is it? (Put N/A if none). *

What are you most looking forward to with this program? Select all that apply. *

Tutoring/Homework Help

Fine Art Enrichment

Core Academic Enrichment

Foreign Language Enrichment

Required

Please check to indicate that you understand the terms and conditions of this program. *

I understand that my application does not guarantee admission.

I understand that, by applying to the program, I am committing to having my child(ren) present each day the program is in session, for the full duration of the session.

I understand that this program ends at 5pm and I must either arrange for transportation of pay for Extra Innings if I am unable to pick up my child(ren).

I understand that Extra Innings ends and 5:30 and that pickup after 5:30 will accrue a late fee of $10. At 5:45, Henderson PD will be contacted.

I understand that each absence, early pickup, or pickup after 5:30 will count as an event. After 3 events in a 4-week period, my child's spot will be released to someone on the waitlist.

I understand that this program has a 3-strike rule when it comes to behavior and my child's spot will be released to someone on the waitlist upon the 3rd incident.

Required

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This form was created inside of Google Apps for Charter Schools.