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Celebration-Town After School Program

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					Celebration Town After School Program 2007 Registration
1. Fill out one registration form per child 2. Return it in person with a $25 deposit 3. Sign waiver form (located on site) Celebration Town: 975 Bacons Bridge Rd, Summerville SC 29483 Name of Child: Address: School that Child attends: Guardian 1: Home Phone: Guardian 2: Home Phone: Relationship: Work Phone: Relationship: Work Phone: Email: Cell Phone: Email: Cell Phone: Photo ID’s are required for pick up Phone number: Phone number: Phone number: Phone number: Grade: City: Birth date: State/zip code:

Authorization for pick up (besides the listed guardians). Name: Relationship: Name: Name: Name: Relationship: Relationship: Relationship:

Please list any medical conditions we should be aware of including: allergies, asthma, medicines, and special needs.


				
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Description: Celebration-Town After School Program