Afterschool Submission Form Please fill out Submission form Afterschool Program Form What date is your child starting? * MM DD YYYY Will your child/children be getting off the bus at the designated windward bus stop? * yes no Student Name * First Name Last Name Students DOB * MM DD YYYY Students Grade Level? * Parents Name * First Name Last Name Email * Phone (###) ### #### Emergency Phone# * (###) ### #### By Chcking yes to any of these questions, I acknowledge that it replaces my signature * yes no Does your child have any Allergies? * yes no If you answered yes to the above question, please explain * Do we have permission to apply bug spray and sunscreen as necessary? * yes no Do we have permission to take phots/videos of your child/children for marketing purposes only? * yes no Thank you!