After School Enrichment Program

After School PicThis page is only for the After School Enrichment Program that Climb On offers at various schools.  If you are a parent at one of these schools and wish to register your child then you’ve reached the right place!

If your school is interested or for more info on adding an After School Climbing program please contact us for more info.

Please fill out the registration form below.

 

Once you register online our office will contact you to confirm space and make payment arrangements.

Thank you!!!

After-School Enrichment Program Registration Form

One form per class per session please

School:*(Required)

Session:*

Class Day:*

Class Time:*

Child’s First Name:*

Child’s :Last Name:*

Grade:*

Room:*

Teacher:*

1) Parent/Guardian First Name:*

Parent/Guardian Last Name:*

Phone (home):*

Phone (cell):*

Email:*

2) Parent/Guardian/Emergency Contact First Name:

Parent/Guardian/Emergency Contact Last Name:

Phone (home):

Phone (cell):

Email:

3) Emergency Contact First Name:

Emergency Contact Last Name:

Phone (home):

Phone (cell):

Where will your child be before class*:

Where will your child go after class*:

In the event of a class cancellation where will your child go?*:

Food Allergies*:

I certify that the above information is true and accurate and that I am the parent or guardian of the Child named above.