First and last name

(Teacher's last name only)

Enter the best phone # to reach you

Work, cell, or other phone # as backup

Enter the best e-mail address at which to reach you for club confirmation or information. If you cannot be reached by e-mail, enter "none".

I certify that I am this child's parent or legal guardian and I give permission for him/her to participate in after-school clubs. I will notify the office if child is sick and unable to attend a club session.

Enter first and last name of contact

Club leaders are volunteers, and the number one problem they have is behavior issues with students who are not really interested in the club activities. Please check with your child that he or she has a genuine interest in the club topic, and discuss appropriate behavior, before registering. We welcome all children into clubs, however, if your child needs one-on-one assistance to participate in the regular classroom, we ask that the family provide an aide to help your child be successful in clubs.

Club leaders often need an extra parent just to be in the room and help out, especially for the younger children. If you would like to help out, please check any days that you would be available.

If you are a leader or committee member, please check here so that we can make sure your child gets in a club.

We will try to give priority to those children who did not get to participate in any clubs last session, however, placement will depend on which clubs the child is eligible for and interested in participating in.