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After School Registration 5-8
After School Program is open Monday-Thursday for tutoring until 4:00. Activity days are Mondays and Wednesdays and these finish at 5:30.
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* Indicates required question
Email
*
Your email
Student's first name
*
Your answer
Student's last name
*
Your answer
Did your child attend any summer program in 2023
*
yes
no
Grade Level
*
5th
6th
7th
8th
Check all that your child will be attending. (Tutoring is required to attend Daily Activity.)
*
Tutoring Monday-Thursday 3:30-4:00
Tutoring Plus Daily Activity 3:30-5:30 Monday and Wednesday
Robotics 3:30-5:30 Tuesday
Required
Parent first name
*
Your answer
Parent last name
*
Your answer
List names of people allowed to pick up your child.
Your answer
Emergency Contact Name
*
Your answer
Emergency Contact Number
*
Your answer
Student is eligible for free or reduced lunch
*
Yes
No
Unsure
I give permission for the 21st Leader to act on my behalf in case of a medical emergency.
*
Yes
No
I give permission for the 21st Century program to take and use images of my child for the purpose of promoting the program on our web site and social media pages.
*
Yes
No
I have read the parent information on the 21st Century Web site located under K-4 information.
*
Yes
No
A copy of your responses will be emailed to the address you provided.
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