AfterSchoolLife

Registration Form

Please fill out one form for each student you wish to enroll.

All information is kept completely confidential and is for After School Life's internal use ONLY.

Cancellation Policy

Select your school to the see the full schedule

Scheduel:

Student Information

First name

Last name

Age

Grade

Pickup

Address

City

State

Zip

Guardian Information

First Name

Guardian last name

Guardian phone

Guardian cell

Guardian email

Emergency Contact

Emergency contact

Emergency relationship

Emergency phone

Medical Conditions

Allergies, Medical Conditions, Medications

Additional Comments

Comments

Payment

Select a Payment Option:

* 3.9% transaction fee will be applied for Paypal & Credit Card payment

By submitting this Registration Form, I agree to waive all claims against the school, After School Life, and their respective staff members for any incident, injury or accident that may occur as a result of my child’s participation in this program. I also agree to allow use of photos, videos taken of the individuals named herein for any Publicity and promotions purposes without obligation or liability to me.