2018-2019 After School Program Registration
This form will be used to enroll your child in the 2018-2019 After School Program. A form must be completed for each child registering. Please note that only the parent/guardians and pick-up contacts will be allowed to pick your child up from the program. Also, payment must be made before the first day of school for your child to stay. Payment can be made Thursday, August 2nd from 10:00 a.m.-1:00 p.m. in the front office. It can also be made at Meet the Teacher Day on August 9th from 3:00-5:00 p.m.
Student Name *
Your answer
Home Address *
Your answer
Grade Level (K-5th only) *
Required
Parent/Guardian Name *
Your answer
Phone Number *
Your answer
Email Address
Your answer
Additional Parent/Guardian
Your answer
Phone Number
Your answer
Email Address
Your answer
Pick-Up Contact #1
Your answer
Relationship
Your answer
Phone Number
Your answer
Pick-Up Contact #2
Your answer
Relationship
Your answer
Phone Number
Your answer
Pick-Up Contact #3
Your answer
Relationship
Your answer
Phone Number
Your answer
Please list any allergies or medical changes that we should be aware of: *
Your answer
Submit
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This form was created inside of Columbia County School District.