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After School Program Registration
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* Indicates required question
Email
*
Your email
Child's Name
*
Your answer
Child's Grade
*
Third
Fourth
Fifth
Parent/Guardian Name
*
Your answer
Parent/Guardian Phone Number
*
Your answer
Parent/Guardian Mailing Address
*
Your answer
Please list any medical needs or allergies that OSLC staff should be aware of:
Your answer
Emergency Contact Name & Phone
*
Your answer
My child plans to participate in:
*
September
October
November
December
January
February
March
April
Required
Home Church (if different than OSLC)
Your answer
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