JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
2020-2021 After School Kids club
Monday-Friday from 3pm-6pm
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Student Name
*
Your answer
Student Grade
*
Choose
PK
Kindergarten
1st
2nd
3rd
4th
5th
6th
Days Per Week - mark all that apply
Will Attend
until 4pm
until 5pm
until 6pm
Only on occasion
Monday
Tuesday
Wednesday
Thursday
Friday
Will Attend
until 4pm
until 5pm
until 6pm
Only on occasion
Monday
Tuesday
Wednesday
Thursday
Friday
Mother's Name
Your answer
Mother's Cell
Your answer
Father's Name
Your answer
Father's Cell
Your answer
Family Physician's Name and Phone
Your answer
Family Dentist Name and Phone
Your answer
Please list any other phone numbers where you can be reached in case of an emergency
Your answer
If there is anything pertinent to your child's care that we should know?
Your answer
Students will only be released to individuals listed on the student release.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Santiam Christian Schools.
Report Abuse
Forms
