Paiute Neighborhood Center

REGISTRATION REMINDERS

—This form may be completed once your registration has been submitted with payment.

—To register for the After-school Program, click here.

—Registration is not complete without payment. Submitted forms without registration and payment are not valid.

—Please fill out one permission form per child.

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Contact Information
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Gender:
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How will your child get home from the program?
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Parent Orientation
Please read our Parent Orientation packet (pdf/1mb/8pp).
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Medical Information
 
Is your child on a prescribed medication that will need to be dispensed during program hours?
If you answered yes, please complete the Medication Consent and Release Form (pdf/93kb/2pp) prior to your child attending the program.