The Program - Preregister

After School Program
Our after school program will begin on Monday, September 19th. The days and hours will be Monday, Tuesday, Thursday and Friday from 2:30 p.m. until 6:00 p.m. and Wednesdays from 1:00 p.m. until 6:00 p.m. The program is for students who are in Kindergarten through 5th grades. Please note that if your child attends a Seattle Public School, you must provide the student ID number as a part of the registration. Please call Jimmy Hurd at 206-717-4775 if you have questions or need additional information.

Pre-Register Below

Please compete the form below. If you have more than one child whom you wish to admit to the program, please complete a separate form for each one. (Please note that pre-registration does not guarantee entry into the program.)

Pre-Registration Form for the After School Program
Please be assured that your information is treated as confidential.

* Indicates required field

Your Name *

First

Last

address *

City, State, Zip *

Phone Number *

Email *

Your Child's Name *

First

Last

Your Relationship with the Child Listed Above *

Your Child's School & ID Number if Seattle Public School *

Your Child's Current Grade Level - Click Arrow for All Options *

Your Child's Ethnic Background (Check all that apply.) *

Other (Description of Ethnic background) *

Are you willing and able to make a donation to help support the program? *

Yes Not at this time

Please share any other comments or questions below. *

Submit

About the Program

Pre-Registration Form for the After School ProgramPlease be assured that your information is treated as confidential.

Pre-Registration Form for the After School Program
Please be assured that your information is treated as confidential.