CompanyThis field is for validation purposes and should be left unchanged.Student Name(Required) First Last Homeroom Teacher/Grade(Required)Click to SelectKindergarten / WongKindergarten / Aikin1st Grade / Wilson2nd Grade / Bacot3rd Grade / Andrisse4th Grade / Melfi5th Grade / Everette6th Grade / Goehring7th Grade / Nasr8th Grade / LinsenmeyerMONDAY After-School Club ChoiceClick to SelectKarate Club - Kaizen Karate - Mondays (K - 5th Grade)Volleyball Club w/ JumpBunch - K - 5th Grade (Wednesdays)Artful Adventures - Creating Cool Characters - Holly Rosario, Mondays (K - 4th Grade)TUESDAY After-School Club ChoiceClick to SelectEco Trekkers w/ EcoAdventures - Tuesdays (K - 4th Grade)Yoga Club w/ Mrs. Bacot - Tuesdays (K - 8th Grade)Tennis Club w/ TGA - 1st - 4th Grade (Tuesdays)WEDNESDAY After-School Club ChoiceClick to SelectLego Club w/ Mrs. Dickson (1st - 6th Grade) - WednesdaysChess Club w/ Silver Knights Chess Academy - Wednesdays (K - 8th Grade)THURSDAY After-School Club ChoiceClick to SelectGymGuyz Move w/ GymGuyz - Thursdays (4th - 8th Grade)WAITLIST ONLY: Yoga Club w/ Mrs. Bacot - Thursdays (K - 8th Grade)Allergies or Health Concerns? (If none, please put N/A)(Required)Parent Name(Required) First Last Parent Email(Required) Parent Contact #(Required)Parent 2 Name First Last Parent 2 Contact #Parent 2 Email Emergency Contact Name(Required)Emergency Contact #(Required)Student Pick-up(Required)Click to SelectParentMustang ClubOtherStudent Pick-Up OtherPlease Choose Your Choice Of Payment Preference:(Required) Billed via FACTS Send in a check made out to SMES By registering my child(ren) for the above program, I, (Parent/Guardian Name), agree to participate or allow my child(ren) and family members to participate and hereby release St. Martin’s in-the-Field Episcopal School, its directors, officers, agents, coaches, parents, and employees from liability for any injury that might occur to myself (or to my child(ren) and family members) while participating in the program. I agree to indemnify and hold harmless the above-mentioned organizations and/or individuals, their agents and/or employees, against any and all liability for personal injury, including injuries or damage to my property, the property to my child(ren), and/or other family members, or both, while participating in the program.Consent(Required) Yes I agree(Required)SignatureTotal Note: In the event that activities are canceled, funds will be applied to the next session of clubs and activities.