City Life Center - 2023-2024 Afterschool Program Registration Form
* * This form will serve to register students for the 2023-2024 fall program conducted by the City Life
Center of Gary, Indiana. This form must be filled out separately for each individual student signing up for
the program.

* The fall program runs daily, Monday through Thursday, from 3:00pm to 6:00pm. Students MUST be
picked up by 6:00pm every day. Pickups occurring after 6:00pm will be charged a late fee of $1.00 per
minute. For example, a pickup at 6:05pm will result in a $5.00 late fee. This fee must be paid in full
before the student can attend the program again.

* When all program spots have been filled, students who fill out this form will be added to a waiting list.
Registered students with 5 or more absences will have their program slot given to a student on the
waiting list. After completion of this form, parents will receive an email indicating whether the student
has been placed in a program slot or on the waiting list.

* There will be a mandatory Parent Meeting on Thursday, September 7, 2023, at 6:00pm for parents and
students registered for the program. Attendance at this meeting will be a pre-requisite for participation
in the program.

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Please initial below that you understand and agree to the City Life Center's pick up, waiting list, program absence, and parent meeting policies.
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