CatCH Program Registration
Session 1 Offerings September 9- December 19
(Course offering descriptions were sent in a previous email and are also available at www.stjsd.org and on Facebook at Catamount Community Hours Afterschool Program)
Email address *
NAME and Birthdate *
Your answer
Teacher/Grade *
Your answer
Parent/Guardian Name and Phone Number *
Your answer
Emergency Contacts should Parent not be able to be reached- please complete if information has changed or not previously provided for prior sessions. (PLEASE INCLUDE: NAME, RELATIONSHIP TO CHILD, and PHONE NUMBERS) Fr *
Your answer
Student allergies or other medical or special needs. Please Specify *
Your answer
What will this student's dismissal plans look like each day they attend the program? *
Required
Please select the Monday course this student would like to attend. (see registration packet for course descriptions)
Please select the Tuesday course this student would like to attend.
Please select the Wednesday course this student would like to attend.
Please select the Thursday course this student would like to attend.
I give permission for CatCH Program Staff to photograph/video my child during program activities or fundraisers. (Photos or videos will be displayed in our school, and may be used in flyers shared with the community, as well as in our school, local newspaper, and CatCH Facebook page) *
I give permission to CatCH Program Staff to take my child off of school grounds to participate in after school field trips. (Parents/Caregivers will be notified prior to field trip dates) *
Comments or questions....
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of The St. Johnsbury School. Report Abuse - Terms of Service