Afterschool Program Registration Form
*No prior experience needed
**Open to students from all elementary schools
Email address *
Student Name *
Your answer
Student's Chinese Name (if one)
Your answer
Parent Name, Number & Email *
Your answer
Parent Name, Number & Email *
Your answer
Student School of Attendance and Grade *
Your answer
Student Birthdate *
MM
/
DD
/
YYYY
Any food allergies center should be aware of? *
Your answer
Any medical conditions center should be aware of? *
Your answer
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