After-School Club Registration Form

Collect the participant's details, emergency contacts, and medical information needed to enroll a child in the after-school club.

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Participant's Name

Nombre

Apellido

Participant's Age

Parent/Guardian Name

Nombre

Apellido

Parent/Guardian Email

Parent/Guardian Phone

Emergency Contact Name

Nombre

Apellido

Emergency Contact Phone

Medical Conditions

Allergies

Authorized Pickup Persons

Parent Only Both Parents Grandparent Other Family Member Designated Adult

How Did You Hear About the After-School Club?

Additional Comments

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