Elementary After-School Program 22/23
PISD's Afterschool Program will be held Monday-Thursday from 3:15 pm until 5:30 pm.

Activities: Tutoring, Chess, Circus Arts, Gardening, 3D Printing, Guitar, Percussion, Violin, Media Arts, Sports Activities, Arts and crafts, And more!

Snacks and Supper will be served.

Pick up time is 5:30pm
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Childs Name and Grade Level(k-5th)   *
Parent/Guardian Name  *
Best telephone number:  *
Emergency contact (Name, Phone Number)
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Can your children be released to the emergency contact?
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If your child will require bussing home from the after-school program, please type your physical address or bus drop-off point below.  *
Please select all activities that your student(s) would like to participate in. This will help guide staff in assigning students to activities.
Circus Arts Activities take place OFF CAMPUS at The Penasco Theater. Do you give your child permission to walk to and from the Penasco Theater for Circus Activities?  *
Is there anything PISD needs to know about your child(ren)? Examples include food allergies, behavioral issues, and anything else that might affect their time during the afterschool program? Please describe anything the school should know
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I understand that activities will take place afterschool and will make sure my child has appropriate clothing/shoes.
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Please type your name below in place of your signature, understanding that typing is the equivalent to signing.
I understand that my child and I will agree to a behavior contract. 
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Please type your name below in place of your signature, understanding that typing is the equivalent to signing.
If for any reason, the medical care providers or hospital on school registration forms cannot be reached, I authorize appropriate transport and medical care to any appropriate medical care provider, hospital or medical facility. This authorization does not cover major surgery unless one other doctor/dentist concurs to the need. Nothing in this section shall be construed to impose liability on any school official or school employee, who in good faith, attempts to comply with this section. It is understood that I will be financially responsible for all emergency care.
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Please type your name below in place of your signature, understanding that typing is the equivalent to signing.
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