Extras form

  • Child Information

  • Parents Information

  • Emergency Contact and Medical Information

  • Signature

  • As the Parent or legal guardian of the above child, I enroll my above child in the Released Time Program,  throughout the school year of 2017/18. 

  • Pick a Date
  • _optional_

    To add more children in the same household, please use the fields below:
  • Should be Empty:
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