Please fill out the information below to enroll your child in our after-school program. You will receive an e-mail confirmation and payment options. We are very excited to have your child as part of our unique after-school program. Please ensure you sign up for newsletters and check our calendar weekly for all the upcoming events.

* Required fields
Name *
E-mail Address *
Child's Name *
Address *
Mother's work address *
Mother's work phone *
Father's work address *
Fathers's work phone *
Father's Cell Phone
Mother's cell phone *
Name of emergency contact *
Address of Emergency contact *
Phone number of emergency contact *
Name of 2nd emergency contact
Address of 2nd emergency contact *
Phone number of emergency contact *

I have read and agree to the Privacy Policy *

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