Registration After School and Summer Programs Registration Form STUDENT INFORMATION First Name (required) Last Name (required) Date of Birth (required) Age (required) Female / Male FemaleMale Cell Phone (if applicable) Student Email Address Grade (required) K123456789101112College Siblings/cousins also enrolled: Sports/Team/Other activities: PARENT/GUARDIAN INFORMATION First Name (required) Last Name (required) Relationship FatherMotherGrandparent(s)UncleAuntSiblingGuardian Address Home Phone Work Phone Cell Phone Parent Email Address Emergency Contact Emergency Contact Phone Emergency Contact Cell Phone PLEASE LIST CLASSES YOU'RE INTERESTED IN AS WELL AS ANY OTHER COMMENTS
