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Date Rec’d _________ Deposit amt.__________ Business Office approval _____________
After School Program Registration Form
Parent’s Name________________________________________________________________________________________ Email Contact_________________________________________________________________________________________ Child’s Name ________________________________________________________________Child’s Grade__________ Days per Week/Pick up Time ___ All ___ 4:00 ___ Monday ___ 5:00 ___ Tuesday ___ 5:30 ___ Wednesday ___ 6:00 ___ Thursday ___ Friday Child’s Name __________________________________________________________________Child’s Grade ________ Days per Week/Pick up Time ___ All ___ 4:00 ___ Monday ___ 5:00 ___ Tuesday ___ 5:30 ___ Wednesday ___ 6:00 ___ Thursday ___ Friday Parent’s Signature _____________________________________ *Please return registration form, along with a $75 deposit per child payable to THS, to Natalia Vekker. **Fee schedule for 2011-‐12 can be found on TowerNet under “Programs” and scrolling to After School Program.
2813 West 17th Street, Wilmington, Delaware