Before & After School Care Waitlist- Kinder-5th Grade

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Please fill out this form if you are interested in placing your K-5th grader on our waitlist for before and/or after school care. This form does not guarantee a spot in the program. You will not receive a response from us, but you will automatically be placed on the waitlist by filling out this form. Please feel free to email us anytime to check the status of program availability. Thank you!

Name of parent filling out form (First and Last) *

Parent e-mail *

Parent phone number *

Child's Name (First and Last) *

Child's DOB *

YYYY

Current Grade (for current availability)

Grade entering (for following school year)

What elementary school will/does your child attend? *

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