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A-3 Enrollment Form

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We have decided to leave 2nd semester enrollment open for now to allow parent/guardians to enroll students as the Covid numbers improve or more people get vaccinated. We must have a completed enrollment for your child to be enrolled in A-3 After School and start attending. Your child may not begin attending until the following Tuesday after the enrollment is returned. A3 will continue to offer virtual A-3 on Monday and Wednesday this semester for virtual students. If you would like your child to attend the virtual option, please send an email to rwade@fcbmustangs.com to let us know. Students already enrolled in A-3 do not need to re-enroll. If you have any questions, please call Natalie Lierle at (405) 590-5550 or Robin Wade-Lynn at (580) 458-2868.

 

Please Fill Out The A-3 Enrollment Form Below



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STUDENT'S FULL LEGAL NAME AS ON BIRTH CERTIFICATE, ADOPTION PAPERS, ETC.:


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Parent/Guardian Information

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Cell Phone(s): (These Phones may receive text messages or notifications)


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Second Parent/Guardian

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Cell Phone(s): (These Phones may receive text messages or notifications)


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Emergency Contact Information
*** We must have at least 2 contacts and a good working phone number at all times.***

PERSON TO CONTACT IN CASE OF EMERGENCY. In order of contact preference:


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Enrollment



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Protecting Your Child

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Student Health History



The Tylenol/Acetaminophen and Chewable antacid are on hand in the office for students with, headache, mild pain, or upset stomach. Please initial which of these you give permission for school personnel to administer to your child:


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Photo/Name Release


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Epinephrine Injection Policy

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Physical aggression against other participants or staff or running away from program activities may result in immediate suspension after the first incident. Participants will forfeit their space from the program for the following reasons: excessive absences, behavior that threatens physical or emotional safety of self or others, or breaking any school rules that are deemed worthy of termination. The program directors’ decision is final.

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A-3 After School does not discriminate against employees or students, on the basis of age, color, disability, gender, gender identity, gender expression, national origin, political affiliation, race, religion, sexual orientation, or any other basis protected by law.


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