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First Choice
Preferred Day
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Preferred Time
4 PM
5 PM
6 PM
7 PM
Between 12 PM and 3 PM
11 AM
10 AM
Number of Spaces
1 Child
2 Children
3 or more Children
Age of Child(ren)
6-7 yrs
8-9 yrs
10-12 yrs
13-17 yrs
Second Choice
Preferred Day
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Preferred Time
4 PM
5 PM
6 PM
7 PM
Between 12 PM and 3 PM
11 AM
10 AM
Number of Spaces
1 Child
2 Children
3 or more Children
Age of Child(ren)
6-7 yrs
8-9 yrs
10-12 yrs
13-17 yrs
Do one or more of these children have special needs or qualify for gifted services through your School District, please specify:
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