Transcript Document
Office Use Only Date and Time Received: Payment: Walker Afterschool Enrichment Registration Classes are on a first come, first serve basis.2015 Registration form and – Spring payment must be turned in to the front office by March 20 . Classes will th begin on Monday, April 6th and go through the week of May 22nd. Registration Students will be put on waiting lists if classes are filled. Each class is $ 20. due to office Are you requesting a scholarships? Y N Student Information: no later than Friday, Child’s Name: ___________________________________ Teacher’s Name: ______________________________ March 20th ! Parent/Guardian: ______________________________________________________________________ __________ Class Selection: Students are to start any after school class by going to the Contact Number: __________________________________ Alternate Number: cafeteria for snack. ____________________________ > If your child would like to sign up for more than 2 classes, priority will be given to other students’ 1st andTuesday 2nd choices before we can placeThursday your student. Friday Monday Wednesday 3-4pm Cafeteri a Library Writing Art French 3-4pm 1:452:45pm Baking Karate 3-4pm 3-4pm Acting Dungeons Potions 1 Magic Potions 2 Art 1st choice: ______________ 2nd choice: ______________ 3rd choice: Room Pick-up ____________________ 4th choice: ________________ At the end of class, my student will be: Information: Picked Up by ____________________ Go to the YMCA Walk Home *pick-up must happen in the room the class is being held (see above)– students will not be Allergy able to Information: walk out to meet someone. A snack is served before each class, please list allergies/food needs for your student. __________________________________________________________________________ __________________________ __________________________________________________________________________ __________________________ Signature and Volunteer Sign-up: I have read and understood all of the information above. If there are any changes to my student’s needs, I understand that I am responsible for notifying the school. Signature of Parent/Guardian _________________________________________ ____________________________ Printed Name: ________________________________________________________ Date: ___________________ I would like to volunteer for