After School - 2024-2025 - Registration Form


First Name:
Last Name:
Boy/Girl:

Date of Birth:

Month

Day

Year



Parent 1 First Name:

Parent 1 Last Name:

Email:
Cellphone:

Area Code

First 3 digits

Last 4 digits


Parent 2 First Name:

Parent 2 Last Name:

Email:
Cellphone:

Area Code

First 3 digits

Last 4 digits


School: