Registration Child Enrollment Form There was an error trying to submit your form. Please try again. Child’s First Name * Please enter your child’s first name. This field is required. Child’s Last Name * Please enter your child’s last name. This field is required. Child’s Date of Birth * Please enter your child’s last name. This field is required. Parent Guardian’s Name * Enter the name of the guardian or parent enrolling the child. This field is required. Parent Guardian’s Address * Enter the name of the guardian or parent enrolling the child. This field is required. Parent Guardian’s Phone Number * Please provide a contact number for the guardian. This field is required. Parent Guardian’s Email * Please provide a valid email address. This field is required. Parent Guardian’s Name This field is required. Parent Guardian’s Address This field is required. Parent Guardian’s Phone Number This field is required. Parent Guardian’s Email This field is required. Allergies/Medical Conditions Please list any allergies or medical conditions. Select Afterschool Location Select an option Cypress Elememtary Hays Elementary Cypress Hill Elementary Activities of Interest Select activities your child is interested in. Art Sports Music Science Please list Start Date and or Additional Notes Any other information you would like to share. Five full days Three full days Drop-In day rate Submit There was an error trying to submit your form. Please try again.