After School - 2025-2026 - Registration Form

First Name:
Last Name:
Boy/Girl:

Date of Birth:

Month

Day

Year


Parent 1 First Name:

Parent 1 Last Name:

Email:
Cellphone:

Area Code

First 3 digits

Last 4 digits

Parent 2 First Name:

Parent 2 Last Name:

Email:

(Must be a different email than the first email you entered)
Cellphone:

Area Code

First 3 digits

Last 4 digits

School:

Hummel