MASD 21st CCLC Afterschool Program Application 2022-2023
The application you are filling out places your child on the waitlist for the MASD 21st CCLC Afterschool Program.  You will be contacted via email when an appropriate slot has opened up for your child to attend the program.

MASD 21st CCLC Afterschool Program is for students in Kindergarten through 8th grade and operates at United at Twin Rivers, Francis McClure and Founders' Hall.

The days and hours of the program are:
  • Founders' Hall begins at 2:30 p.m. and concludes at 5:30 p.m. on Monday, Tuesday, Wednesday and Thursday
  • United at Twin Rivers and Francis McClure begins at 3:00 p.m. and concludes at 6:00 p.m. on Monday, Tuesday, Wednesday and Thursday
The starting dates for the program are:
  • 3rd - 8th graders on October 5, 2022
  • 1st - 2nd graders on October 17, 2022
  • Kindergartens on October 25, 2022
There is no transportation provided for students who attend the program.

The Afterschool Program will keep your child stimulated during the afterschool hours. The program encourages learners to think outside the box. All students will receive:
  • STEAM: Science, Technology, Engineering & Design, Arts, Mathematics
  • Reading & Language Arts
  • Physical Education
  • 20- minute Homework Help Session
  • Dinner & a Snack Space is limited so sign up early to avoid being placed on the waiting list.

All communication for the program will come via email so please provide a working email address.

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Student's Name *
Student's Homeroom *
Student's Grade *
Student's School *
Name of Parent/Guardian (s) *
Student Address *
Phone # *
Parent Email Address (All communication will come via this Email Address) *
Please list the names of sibling(s) applying for the program.   *
ADDITIONAL EMERGENCY CONTACT INFORMATION
Name of Emergency Contact Number 1 *
Phone Number of Emergency Contact Number 1 *
Name of Emergency Contact Number 2
 *
Phone Number of Emergency Contact Number 2
 *
HEALTH CONCERNS
List any Allergies *
List any Medications taken at School *
List any limitations to activities caused by medical conditions. *
PERMISSION TO USE PHOTOS/VIDEOS
Please be advised that your child may be photographed or video recorded.  We may use the photos/videos in our district social media or news releases. *
TRANSPORTATION
Provide the method that your child will utilize to get home from the program. *
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