Enrichment_Reg_PE_Winter_17

3-Month Enrichment - Last Minute Open Gym Registration

* Indicates required field

Child's Name *

First

Last

Teacher (Only grades 3, 4 and 5 are eligible.) *

Parent/Guardian Name *

First

Last

Parent/Guardian Email *

Parent/Guardian Email 2 (optional) *

Parent/Guardian Phone *

Parent/Guardian Phone 2 (optional) *

Person Responsible for Picking Student Up *

First

Last

Person Responsible for Picking Student Up - Phone # *

Does your child attend the Y's after-school program at Tuscan? *

Yes, my child attends the ASP and I will contact the Y for the required form.

Is there anything you would like the instructors to know about your child? Any allergies or other concerns? *

Tuscan ROAR Behavior Contract (Respect Others, Act Responsibly) *

Yes! My child agrees to respect every teacher or other adult by being polite and following directions, respect other students by showing caring and kindness, and have a postive attitude and give their best effort in every way.

Does the Tuscan PTA have permission to use your child's image to promote its programs? *

Yes No

Does your child have permission to walk home after enrichment? *

Yes! My child has permission to walk home after enrichment. I understand that no crossing guard is on duty at dismissal time. No. My child can only be dismissed to his or her designated pickup person.

Are you interested in volunteering to help with Enrichment? *

Yes! I'd like to learn more about volunteering to help with Enrichment.

No child will be denied enrollment in the Enrichment Program due to financial hardship. Scholarships are available to those students who receive free or reduced-price lunch. There are a limited number of scholarships available, and students will be asked to pay $50 toward the class fee, if possible.

Scholarship Request *

Please check this box if you are eligible and would like to request a PTA-funded scholarship for an Enrichment class.

Please select a first-choice class and any additional backup choices in order of preference. Note that we can only accommodate one choice per student unless there are still spaces available after enrolling every student in at least one class.
Please check the box below if you are interested in more than one class. If space is available we will consider your backup choices in order of preference.
Please submit payment for a single class at this time. We will get in touch with you if we were able to place your child in any additional classes.
Enter any additional comments as well that may relate to your preferences. We try our best to accommodate all requests!!!

First Choice *

Enter any comments relating to your class preferences below *

Submit and Continue to Payment