Summer Extended Day Registration

Summer Extended Care Registration

To register your scholars, please take the time to fill out the information below.

How many children will attend?

Child 1 First and Last Name

Child 1 Physical Address

Child 1 Birthday

Child 1 Grade Level

Child 1 Gender

Child 1 Teacher

Child 1 Medical Concerns or Allergies

Child 1: Other Important information to share regarding your child

Child 2 First and Last Name

Child 2 Physical Address

Child 2 Birthday

Child 2 Grade Level

Child 2 Gender

Child 2 Teacher

Child 2 Medical Concerns or Allergies

Child 2: Other Important information to share regarding your child

Child 3 First and Last Name

Child 3 Physical Address

Child 3 Birthday

Child 3 Grade Level

Child 3 Gender

Child 3 Teacher

Child 3 Medical Concerns or Allergies

Child 3: Other Important information to share regarding your child

Child 4 First and Last Name

Child 4 Physical Address

Child 4 Birthday

Child 4 Grade Level

Child 4 Gender

Child 4 Teacher

Child 4 Medical Concerns or Allergies

Child 4: Other Important information to share regarding your child