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 ChoiceiCode Foundations Tech Club - 1st - 3rd Grade (Mondays)Click to SelectArt Adventures: Blacklight Glow Art w/ Holly Rosario - Mondays (K - 4th Grade)TUESDAY After-School Club ChoiceClick to SelectTennis Basics w/ TGA - Tuesdays (1st - 4th Grade)Yoga Club w/ Mrs. Bacot - Tuesdays (K - 8th Grade)WEDNESDAY After-School Club ChoiceClick to SelectChess Club w/ Silver Knights Chess Academy - Wednesdays (K - 8th Grade)THURSDAY After-School Club ChoiceClick to SelectYoga Club w/ Mrs. Bacot - Thursdays (K - 8th Grade)Eco Trekkers w/ Eco Adventures - Thursdays (K - 4th 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. URLThis field is for validation purposes and should be left unchanged.