Winters Elementary BLAST Form
If you have more than one child attending, please fill out a form for each child! 

August 8, 2023 -September 28, 2023 
Monday through Thursday
4:00-5:15
Dismissal starts at 5:05 to 5:15 each day. 

September 29, 2023- May 23, 2024
Monday through Thursday 
4:00-5:15
Dismissal starts at 5:05 to 5:15 each day. 
Non-instructional Friday
7:30 AM to 12:30 PM 

Breakfast and lunch will be provided on Fridays.
There will not be an early pickup time available

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Students Name *
Homeroom Teachers Name *
Grade *
What day will your child be attending. Please check all that will apply.  *
Required
How will my student get home from after school care?
 *
Pick- up
Walk
Bus
Monday
Tuesday
Wednesday
Thursday
Friday
Participation in the Winters ISD After School Program is a privilege. A child must follow the rules of the program. Winters ISD After School Program supports all core day school rules. Disruptive or disrespectful behavior towards other students or staff will not be tolerated, the student will be dismissed from the After School Program.
*
Parent Name
 *
Parent Phone Number
 *
Secondary Contact Name
Secondary Contact Phone Number
Emergency Contact Name 
Emergency Contact Phone Number
Submit
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