Glidden Community Learning Center Registration Form 2020-21
Please be sure to read the Parent Handbook linked below before filling out the registration. Please fill out a separate form for each child. Once your child is registered, you will receive additional information regarding the program.
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Email *
Handbook link below
https://docs.google.com/document/d/1hcMr6YGtDJ-v6hcne8086-ngRQiOps8KakW4YPxM8LU/edit?usp=sharing
Student Name *
Student Grade Level 2020-2021 School Year *
Parent/Guardian Name #1 *
Parent/Guardian Email #1 *
Parent Phone Number #1 *
Parent/Guardian Name #2
Parent/Guardian Email #2
Parent Phone Number #2
 #1 Emergency Contacts and phone number *
 #2 Emergency Contacts and phone number *
Authorized Pick-Ups: The people listed below will be the ONLY people allowed to pick-up your child in addition to the parents and guardians listed. *
Enrollment
Please choose which programs you would like to enroll your child in.
Before-School Program (6:00 A.M. - until the school day starts) Monday-Friday when school is in session. Grades 4K-8th grade. Check all that apply.
After-School Program (after the school day - 5:00 P.M.) Monday-Thursday when school is in session. 1st grade-8th grade. Check all that apply.
Playgroup (after the school day - 5:00 P.M.) Monday-Thursday when school is in session. 4K-5K. Check all that apply.
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