January 2022

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
January 3-7, 2022
January 10-14, 2022
January 17-21, 2021
January 24-27, 2021
Participant Information
Parent / Guardian Information
Other Information