ReZ Site 2021-22 AFTER SCHOOL Wait List

Please complete the form below to be added to our wait list! (If you have multiple children, please complete one form per child.)

Parent's First Name *

Parent's Last Name *

Child's First Name *

Child's Last Name *

Child's Birthday * +

Grade: *

Which school does your child attend? *

Other School: (Must be dropped off at the center after 2:30) *

Phone Number *

Email Address *