Good success Kaleidoscope kids Online Registration

Registration

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Welcome to Good Success Kaleidoscope Kids after school/ OST Program 2023/2024. $50 non-refundable registration fee will secure your child a spot. $350 a month for 1st grade to 5th gr. $400 for 3k, 4K, and Kindergarten. A 10% sibling discount is available for full time After-School students. ALL fees are paid to gskaleidoscopekids@gmail.com using Zelle (include your child's name in the memo area). The monthly tuition is paid by the first day of the month.

* denotes required fields

Referral Information

How did you hear about us?*

Referral Name

Childs Last Name

financial account Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Emergency Contact Info (Not Contact #1 or #2)*

Health Insurance Carrier

Authorized Pick up 1*

Cell/Relationship*

Authorized Pick up 2*

Cell/Relationship*

Contact #1

Guardian #1 information First Name*

Last Name *

relationship*

How Can We Contact You?

Home Phone *

Work # *

Cell # *

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Who is your employer?

Employer*

Employer Phone*

Employer Notes

Contact #2

Guardian #2 information First Name*

Last Name*

relationship*

How can we contact you?

Home Phone *

Work # *

Cell # *

Email* (Emails are kept confidential)

Confirm Email*

Who is your employer?

Employer*

Employer Phone*

Employer Notes

Student #1

Student's First Name*

Last Name*

Birth Date*

Cell #

Additional Info

T-Shirt Size

School*

Grade Level*

Disabilities*

Special Needs*

Allergies*

Medications*

Primary Doctor*

photo permission yes*

Please use the class feature to enroll your child in their upcoming grade starting September 7, 2023.

Thank you for your registration.

Your registration fee will hold your spot. However, Payment of the monthly fee sent to gskaleidoscopekids@gmail.com is your confirmation of enrollment.

Classes are age appropriate.

Classes are in separated locations based on age.

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Cell #

Additional Info

T-Shirt Size

School*

Grade Level*

Disabilities*

Special Needs*

Allergies*

Medications*

Primary Doctor*

photo permission yes*

Please use the class feature to enroll your child in their upcoming grade starting September 7, 2023.

Thank you for your registration.

Your registration fee will hold your spot. However, Payment of the monthly fee sent to gskaleidoscopekids@gmail.com is your confirmation of enrollment.

Classes are age appropriate.

Classes are in separated locations based on age.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Cell #

Additional Info

T-Shirt Size

School*

Grade Level*

Disabilities*

Special Needs*

Allergies*

Medications*

Primary Doctor*

photo permission yes*

Please use the class feature to enroll your child in their upcoming grade starting September 7, 2023.

Thank you for your registration.

Your registration fee will hold your spot. However, Payment of the monthly fee sent to gskaleidoscopekids@gmail.com is your confirmation of enrollment.

Classes are age appropriate.

Classes are in separated locations based on age.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Cell #

Additional Info

T-Shirt Size

School*

Grade Level*

Disabilities*

Special Needs*

Allergies*

Medications*

Primary Doctor*

photo permission yes*

Please use the class feature to enroll your child in their upcoming grade starting September 7, 2023.

Thank you for your registration.

Your registration fee will hold your spot. However, Payment of the monthly fee sent to gskaleidoscopekids@gmail.com is your confirmation of enrollment.

Classes are age appropriate.

Classes are in separated locations based on age.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Cell #

Additional Info

T-Shirt Size

School*

Grade Level*

Disabilities*

Special Needs*

Allergies*

Medications*

Primary Doctor*

photo permission yes*

Please use the class feature to enroll your child in their upcoming grade starting September 7, 2023.

Thank you for your registration.

Your registration fee will hold your spot. However, Payment of the monthly fee sent to gskaleidoscopekids@gmail.com is your confirmation of enrollment.

Classes are age appropriate.

Classes are in separated locations based on age.

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Registration

Referral Information

Childs Last Name

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Who is your employer?

Contact #2

How can we contact you?

Who is your employer?

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #4 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

Required Policies (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Required Policies

(Show-Hide Details)