Enoch 2020-2021 Registration
Registration Fee: $21 per child

*We follow the Iron County School District Calendar for holidays and breaks. If, for any reason, changes are
made to our calendar you will be notified by email.

*Payment may be made by: Check, Debit/Credit (through our website), or Venmo (@Afterschoolallstar).
State childcare assistance through DWS and SUU childcare assistance are accepted if you qualify.
Email address *
Child's Name (First & Last) *
Date of Birth *
Grade *
Teacher *
Child's School ID (Lunch Number) *
Does this child qualify for free or reduced lunch? *
List any allergies/medical conditions *
Parent/Guardian (First & Last) *
Primary Phone *
Alternate Phone *
Designated Adults: Only a parent/guardian or designated adult is allowed to pick up children from the program. Please list name(s) and phone number *
Emergency Contact Information: Please include name, phone, and relationship to child *
You understand that all program staff are CPR/First Aid certified and you give program staff authority to act in your child's best interest, should any medical care become necessary. *
You understand that children and parents are expected to follow all program rules. *
You give consent for Afterschool All-Stars to use photos and/or videos of your child on their social media and marketing tools (Facebook, Instagram, & www.afterschoolallstar.com) *
You give permission for your child to participate in program data collection (student names will not be recorded in data collection) and take surveys that pertain to the afterschool program, nutrition, physical activity, and building positive relationships. *
You are the parent or guardian of the child listed in this registration form. You give permission for your child to participate in Afterschool All-Stars activities during the 2020-21 school year and you agree that Afterschool All-Stars is not liable for any injuries or lost items. *
Additional Information (Please indicate here if your child will be attending part-time or Wednesdays only)
A copy of your responses will be emailed to the address you provided.
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