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WO After School Enrichment Programs
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Name of Student (First and Last)
*
Your answer
Grade
*
2nd Grade
3rd Grade
4th Grade
5th Grade
Current Program
*
My Child is currently enrolled in the Boys and Girls Club ASES
My child is currently enrolled in the Boys and Girls Club ELOP
My child currently does not stay after school. This will be their first time.
Parent/Guardian Name
*
Your answer
Parent/Guardian Contact Number
*
Your answer
Email
*
Your answer
Option Selection
*
I want my child to only attend soccer.
I want my child to only attend dance classes.
I want my child to only attend art classes.
I want my child to attend all three classes.
Questions/ comments
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Your answer
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