Afterschool Registration Form
Please complete this form for each student you will be registering for the Afterschool program.
1. Student Information
Student's Name *
Student Date of Birth *
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/
DD
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Grade Level *
List any Allergies, Chronic Illnesses, or Medications *
Parent/Guardian information will be pulled from the Student Information System. This will include emergency contact, pick-up, and medical information. Is there any additional information you would like to add?
Clear selection
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