AFTER SCHOOL Program Registration Form
Child's Full Name (required)
Child's Year & Month of Birth 20232022202120202019201820172016201520142013 JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember
Your Childs School:
Pick your desired day : Mondays 3:00-4:30 pmTuesdays. 3:00-4:30 pmWednesday. 3:00-4:30 pmThursdays 3:00-4:30 pmFridays 3:00-4:30 pm
Start Month --select month--JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember
Your Name
Your Email
Confirm Your Email
Mobile Number
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