After School Program Details

First Name

Last Name

Phone

Name (1st Child)

Birth Date (1st Child)

Allergies (1st Child)

More Info (1st Child)

Name (2nd Child)

Birth Date (2nd Child)

Allergies (2nd Child)

More Info (2nd Child)

Name (3rd Child)

Birth Date (3rd Child)

Allergies (3rd Child)

More Info (3rd Child)

IMPORTANT: People Approved For Child(ren) Pickup

Please list each person on their own line along with the relationship to the child. List anyone approved (other than the person booking the event), who is allowed to pickup the kids. If none, say NONE.
Example:
Sarah Conner - Aunt
Jason Drakes - Friend

People Approved