Enrichment Program
Middle School
Registration Form

Program Information | Course Offerings | Program Policies | Registration

Class sizes are limited and registration is on a first come, first serve basis. You will only be notified if a class you selected is full. Please refer to this website for start dates and times. Homework clubs and Enrichment classes do not run on half days. No refunds will be issued after the start date of classes.

Printable Form

SESSION I ENRICHMENT REGISTRATION - MIDDLE SCHOOL
Student's Name:   Grade:  
Home Room Teacher:  
Mailing Address:   Home Telephone:  :
City:   Work/Cell Telephone:  
Email:
Medical Concerns:
 
 
Allergies:
 
 
 
Emergency Contacts (in the event you cannot be reached):
Name:   Telephone:  
Name:   Telephone:  

Can we use photos for any media including our web site? No names will be included __ Yes __ No

Please list course selection(s) and return with payment to the Middle School Office, bring to our offices at the Harwich Elementary School, or mail to address above NO later than Tuesday, September 21st. Do not delay as classes fill quickly. Make check payable to the TOWN OF HARWICH.

Course No. Name of Course Fee
     
     
     
     

Please Sign: I give permission for my child to take enrichment courses stated above:

Signature: Date:
Check all that apply:
___ My child has permission to take the late bus at 3:15 PM.
___ My child will be picked up after the course.
___ My child has permission to walk home after the course.

The Harwich Public School district does not discriminate on the basis of race, sex religion, national origin, sexual orientation or disability.

School Age Care | Enrichment | Adult Education | About Us | Contact | Home

Harwich Community Learning Center Program
PO Box 759
Harwich Port, MA 02646
(508) 430-2355
(508) 430-7224 (fax)

Webmaster: FBJ Associates.
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