23-24 Registration Request Form 
Hello!

Please complete the form below if you are interested in registering for the 23-24 YMCA School Year Programs!  Please note, all of our programs are currently at capacity so you will be added to the waitlist. When a space opens up, we will reach out to let you know via email. 

Program Fees:
$30 registration fee
$390 a month for 5 days of After Care 
$280 a month for 3 days of After Care
$155 a month for Before Care (if applicable) 

If you are interested in learning more or seeking out financial aid opportunities, please reach out to our billing coordinator, LaVerne (lmayomi@ymcachciago.org). 

If you have any further questions please email our program team at; lakeviewbeforeafter@ymcachicago.org

Please fill out 1 form per child.
Sign in to Google to save your progress. Learn more
Email *
Child's Full Name (First and Last) *
Child's Date of Birth *
MM
/
DD
/
YYYY
Parent's Full Name  *
Parent Phone Number *
Child's Address
What School Will Your Child Be Attending for the 23/24 School Year? *
What grade will your student be in for the 23-24 school year? *
Please indicate what days of the week that your child will need after care. We offer 3 or 5 days a week options, please select a minimum of 3 days.
 *
Required
If there is Before Care at your school, would you be interested? (Program is dependent on interest and school contract) 
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of YMCA of Metropolitan Chicago. Report Abuse
Google Forms