2024-2025 HELUS Expanded Learning Opportunities Program (ELOP) Before & After School & Camp Registrations
New Registrations are required to participate in ALL afterschool and non-school day/camp activities for the 2024-2025 school year.  Each student will require their own registration form.  

Enrollment may vary for students by family preference from 1 class/club a week for an hour, to as many as 3 hours each weekday Monday through Friday. *Sign-Ups will be required prior to non-school day activities for staffing purposes.* classes/clubs options and days/times will be forthcoming.

ELOP Handbook for Parent-Guardians  Read and sign last TWO pages to complete registration.
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Email *
Based out of AREA 18 (room 18) "We're Outta This World!"
Student Name (First & Last) *
Grade Level *
What after school days will your student attend? *
Required
Will your student attend the morning hour? 7:00 - 8:00 am in room 18 *
Required
What CAMP days will your student attend *
Required
Medical Issues / Food Allergies (mark none if this does not apply) *
PARENT-GUARDIAN INFORMATION
Parent/Legal Guardian Name *
Parent/Legal Guardian Address/Zip *
Parent/Legal Guardian Phone Numbers *
Parent/Legal Guardian Email Address *
Parent/Legal Guardian Email Address *
SIGN OUT INFORMATION
Safety is a top priority to HELUS therefore no child enrolled will be released from the program without a parent/guardian signature or that of one of the individuals listed below, if the parent cannot be reached. (Note: The names below must be someone 18+ years old with a valid identification).

Please provide: Name, relationship, phone number
Sign Out Designee's Name, Relationship, and Phone Number
EMERGENCY INFORMATION
In the event of an emergency, the following information will be used to provide emergency response team information for care of your student.
Physician Name and Phone Number
Medical Insurance Carrier and ID#:
Medi-Cal #:
Hospital used in an Emergency
Are there any medical, family circumstances or cultural requirements of which the leader should be aware of (Any known allergies)?
Current regular medications
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