April 2019 Request Form

Please select the dates (minimum 4) that you require after school care as well as the other fields.

For multiple participants from the same family, we ask that you complete this form again.

All Dates Listed Below
April 1 - 4, 2019

*PA Day April 5, 2019

April 8 - 12, 2019
April 15 - 18, 2019

*Holiday April 19, 2019

April 23 - 26, 2019

* Holiday April 22, 2019

April 29 - May 3, 2019
Participant Information
Parent/ Guardian Information
Other Information