After School Study Schedule



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1 KJ Afterschool Registration Form Child’s Name Age:DOB:Grade:Teacher: Child’s Name Age:DOB:Grade:Teacher: Child’s Name Age:DOB:Grade:Teacher: Parent/Guardian Name(s): Home Address: E-mail Address: Cell : Work : Home : 1st Emergency Contact’s Name: Relationship: Phone : 2nd Emergency Contact’s Name: Relationship: Phone : Does your child have any allergies Yes or No If yes, what are they allergic to, and do they need an epi-pen Does your child take any medications Yes or No If yes, what medication Behavior Expectation Each child will be expected by the staff to maintain equal behavior standards to that of Greensboro Academy..

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