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Registration - Pilgrim Church After School Drop In
K - 3 students from Harwich Elementary School year 2024 - 2025
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* Indicates required question
Child's Name
*
Your answer
Age/Grade
*
5
6
7
8
9
10
11
Grade K
Garde 1
Grade 2
Grade 3
Grade 4
Required
Birthdate
*
Your answer
Parent/Guardian Name
*
Your answer
Phone Number
*
Your answer
Email for Contact
*
Your answer
Days Attending
*
Monday
Tuesday
Wednesday
Thursday
Friday
Required
Regularly Scheduled or Drop In or Both
*
Regularly Scheduled
Drop In
Combination of both
Required
Who will be picking up your child most often?
*
Your answer
People with Permission to pick up your child (please include contact phone)
*
Your answer
Does your child have food allergies? If so, what?
*
Your answer
Anything we should know about?
*
Your answer
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