FY24/25 Fee-Based Before and After School Program Registration
This form is an application for the before and after school program. Please note that our enrollment is limited based on staffing and may be closed to new enrollment at any time during the year.

Please read through the guidelines of the program by clicking on the link here, FY24/25 Before and After School Guidelines.  

Please fill out a form for each of your children that you wish to enroll in our  program and fill out a separate form for each child.

THIS IS NOT YOUR PAYMENT OF REGISTRATION, THIS IS JUST TO HOLD YOUR SPOT.  
THE $25 REGISTRATION FOR INDIVIDUALS or $40 FOR FAMILIES,  WILL BE COLLECTED AT THE SCHOOL TO FINALIZE YOUR COMMITMENT. 
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Email *
I understand that I must pay $25 for individual student and $40 for families to secure my spot for the 24-25 school year. Registration is not complete without the payment. *
Required
Student Last Name *
Student's First Name *
Student's grade level for the upcoming school year: *
Student's home address (street address, city, and zip code) *
Parent/Guardian#1  First and Last Name: *
Parent/Guardian #1 Phone Number: *
Parent/Guardian #2 First and Last Name: *
Parent/Guardian #2 Phone Number: *
Please indicate the program your child is signing up for.  Please note, your child can only attend the specific program you choose. *
I understand that I will be required to pay a $25 registration fee ($40 per family) to hold spots in the program. *
I have read and agree to the linked *
Additional approved person that may pick up your child:
First and Last Name & Phone Number
*
Additional approved person that may pick up your child:
First and Last Name & Phone Number
Additional approved person that may pick up your child:
First and Last Name & Phone Number
Does your child have any allergies or other medical conditions that you would like to make us aware of? (If yes is selected, please also answer the next question) *
Please elaborate on any allergies or medical conditions that you would like to make us aware of. Please skip this question if you answered no to the previous question.
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