IN-richment After school Program

The "IN-richment Afterschool Program" is an innovative initiative designed to foster curiosity and creativity in young minds through hands-on activities, personalized tutoring, and engaging workshops, aiming to empower students with critical skills for the future. This program offers a dynamic learning environment where children learn about leadership development while building teamwork and problem-solving abilities.

Your name *

Email address *

Phone number *

Address *

STUDENT INFORMATION

Number of students enrolling into the afterschool program *

Select afterschool location *

Provide first and last name of all individuals authorized for pick up. *

Example: William Brooks

EMERGENCY CONTACT & MEDICAL INFORMATION

Emergency Contact 1 (Name) *

Emergency Contact 1 (Phone) *

Emergency Contact 2 (Name) *

Emergency Contact 2 (Phone) *

Medical note *

please list your child's name, allergies or any important medical information

PAYMENT INFORMATION

To complete your application please provide the necessary payment information below. This information is essential for processing program fees and securing your child's participation

Select primary tuition payment method *

Credit/Debit Card

ACH (Bank Account)

By checking this box, I hereby authorize INtentional Church to initiate automatic ACH transfers from my bank account or charge my provided credit/debit card for the purpose of securing weekly tuition payments for the IN-richment Afterschool Program. *

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