Summerfield Elementary Afterschool Registration

This program meets on Thursdays from 2:15-3:30pm at Summerfield Elementary from January 12th through April 6th. Students will be cast in a “learning performance” that will be performed for families on April 6th at 3:30pm.

To enroll your student in the Stagelights Summerfield Elementary Afterschool Program, please complete the form below. Shortly after, you will receive a confirmation email with your enrollment and an invoice for the program.

Parent Name

First Name

Last Name

Primary Phone

(###)

###

####

Student #1 Name

First Name

Last Name

Student #1 Date of Birth

YYYY

Student #1 Homeroom Teacher

Student #2 Name

First Name

Last Name

Student #2 Date of Birth

YYYY

Student #2 Homeroom Teacher

Student #3 Name

First Name

Last Name

Student #3 Date of Birth

YYYY

Student #3 Homeroom Teacher

Emergency Contact Name

First Name

Last Name

Emergency Contact Number

(###)

###

####

Summerfield Elementary Policy: If children are picked up late two times, they will not be allowed to continue with the program and no refund will be given.

I agree

This program is for enrolled SES students only. No transportation is provided.

I agree.

Tuition for this program is $215, with 10% sibling discounts.

Please invoice me for the full balance due January 12th.

Please invoice me in two equal installments, due January 12th and February 23rd.

I will be applying for scholarship assistance.