Name of Adult * First Name Last Name Email * How old are your children? * What days are your children able to attend programming? * Please select all that apply. Mondays after school hours Tuesdays after school hours Wednesdays after school hours Thursdays after school hours Fridays after school hours Saturdays Where can your children safely and reliably travel to for programming? * Please select all that apply Wadsworth Hall Pitt Trees Hall Pitt Trees Athletic Complex Hill District CDC Homewood CDC Will your child require food support to attend programming? * Yes No Which of the following activities would your child(ren) be excited to join? * Software and game programming Engineering basics Tradecraft (basic home repair) Outdoor sports Indoor sports Fine arts Crafting from household items Music education None of these Thank you! Activities Activities Activities
