After-School Sign-up

Name *
Name
Please provide the student's name that will be taking the class
Phone 2 *
Phone 2
Student's cell phone number
Name 1 *
Name 1
Parent's name
Phone *
Phone
Name 2 *
Name 2
Name of person that will be picking student up from class. If student is able to walk home on their own, please put 'self' in this space
Phone 1 *
Phone 1
Phone number of person picking child up
Which day will you attend afterschool class?