After-School Application — Budding Minds: Nature-Based Discovery Program

Budding Minds After School Application Form

Please complete this application form if you would like your child to join the Budding Minds After School Program. Submitting this form does NOT guarantee your child’s spot in any program. Spots will be given on a first come first serve basis and you will be contacted by email to confirm your child’s spot or to notify you that your child has been placed on our waitlist.

Name of Child

First Name

Last Name

Child's Birthdate

YYYY

Current Age of Child

Which school will your child be attending?

Alexander Park Elementary School

Ecole La Confluence

Which days of the week would you like your child to attend? (Choose any combination of days)

Mondays

Tuesdays

Wednesdays

Thursdays

Please indicate what date you would like your child to start (if different than our program start date)

Name of Parent or Guardian

First Name

Last Name

Phone

(###)

###

####

Additional Information

Please indicate here if have any special requests