Afterschool Fall 2021 Enrollment Written by Jen Osha, August 15th, 2021 Afterschool Enrollment Form Fall 2021 Child to Enroll*Please list last name first. One child only.Last NameFirst Name (and applicable Nickname)Child Information*Date of Birth and Age are required!Date of BirthAge (at beginning of semester)School Parent/Guardian 1 Email*Mtn SOL communicates with parents/guardians primarily through email. At least 1 email is required. Changes to Contact and Permission Information?*Please review the fields below requesting contact information and photo/video permissions. Please check one of the following:No changes in this information since my child's last enrollmentThere are changes since my child's last enrollment OR this is a NEW enrollmentChild's Home Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Parents / Guardians*To add additional parents or guardians, click the plus sign on the right. At least 1 phone number is REQUIRED for each person.NameRelationshipPhone, WorkPhone, Cell Parent/Guardian 2 Email Photo/Video Permissions*Please check one of the following:I hereby grant permission for my child to be included in evaluation and photographic pictures, including video/audio recordings, connected with the afterschool program.Check here if you permit your child to be in photos and videos, but not the use of his/her name.Check here if you do NOT grant permission for your child to appear in any photographs, video or audio recordings.Emergency Form*A complete and updated emergency form must be on file with Mountain SOL prior to attending afterschool programs (see Emergency Contact form for additional details). Please check one of the following:I will submit a completed & updated emergency form.I have completed an emergency and medical form in the last year and no information has changed.Class SelectionMountain Mallards 2nd - 4th gradeMondays, 4pm - 5:30pm Mountain Mapaches4th - 6th gradeThursday, 4pm - 5:30pm Mountain Zorros/Owls6th - 8th gradeWednesday, 4pm - 5:30pm Wildcraft Wednesdays4th grade and upWednesdays, 4pm - 5:45pm Mountain Jaguares8th grade and upThursday, 5:00pm - 6:50pm WE MUST RECEIVE PAYMENT TO RESERVE YOUR SPOT IN CLASS.How many classes are you enrolling?*This should be the TOTAL number of classes in which you're enrolling your child. 12Class #1Choose a classMallardsMapachesZorrosJaguaresWildcraft WednesdayWe continue to offer sliding scale pricing to help make the program affordable to all of our families. Prices range from 150 to 200 for all programs except for Jaguares, which is 175 to 225.New Owls ProgramCheck here if your child will be in the new Owls programMallards MONDAY Fall 2021 Pricing$150$160$170$180$190$200Mapaches THURSDAY Fall 2021 Pricing$150$160$170$180$190$200Wildcraft Wednesday Fall 2021 Pricing$150$160$170$180$190$200Zorros Wednesday Fall 2021 PricingThis includes the new Owls program$150$160$170$180$190$200Jaguares Fall 2021 Pricing$175$185$195$205$215$225Class #2Choose a classMallardsMapachesZorrosJaguaresWildcraft WednesdayWe continue to offer sliding scale pricing to help make the program affordable to all of our families. Prices range from 150 to 200 for all programs except for Jaguares, which is 175 to 225.New Owls ProgramCheck here if your child will be in the new Owls programMallards MONDAY Fall 2021 Pricing$150$160$170$180$190$200Mapaches Thursday Fall 2021 Pricing$150$160$170$180$190$200Wildcraft Wednesday Fall 2021 Pricing$150$160$170$180$190$200Zorros Wednesday Fall 2021 PricingThis includes the new Owls program$150$160$170$180$190$200Jaguares Fall 2021 Pricing$200$210$220$230$240$250Method of PaymentI will pay with Paypal now (there is a 4% PayPal surcharge)I will mail a check immediately. 50% is required to hold your spot.We ask you please to take care of your payment at the time that you sign up. Thank you! Please make checks payable to: Mountain SOL 130 Discovery Place Morgantown, WV 26508Paypal surcharge $0.00 Parent/Guardian Signature*By typing your name and clicking the submit button you are agreeing to provide an emergency contact form (if not already submitted) and pay for the class. This constitutes a legally binding signature just like a handwritten one. Total $0.00 If you have selected Paypal, you will be directed to paypal after you hit the submit button. Share this:FacebookTwitter
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