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Wesleyan Christian Academy > Apply to Wesleyan > Continuous Enrollment > After School Program Registration

After-School Program Registration

Student Information

Student's Name(Required)
MM slash DD slash YYYY
Student's Gender(Required)
Academic School Year(Required)
What year will you need After-School Care?
Student's Grade Level(Required)
After-School Care is only available for Wesleyan students enrolled in TK through 5th-grade.
After-School Program Options(Required)
The program you select below is for the entire school year. Changes can only be made quarterly and must be approved by Wesleyan’s After-School Care Coordinator. Please contact afterschool@wcatrojans.org.
Does the student have any siblings enrolled at Wesleyan Christian Academy?(Required)
Who has primary custody of the student?(Required)

Parent Information

Parent 1 Name(Required)
Parent 2 Name

Student's Medical Information

Please describe any medical conditions the student might have. This information will be kept confidential and is only used to serve your child better.
Doctor’s Name or Practice Name
Include Area Code
Address, Street, City, State
Emergency Care Agreement(Required)
I agree that Wesleyan Christian Academy’s After-School Care Coordinator or his/her designee may authorize a licensed physician or medical professional to provide emergency care to my child in the event my child’s physician nor I can be contacted immediately.

Student Pick-Up Permissions

Please list any individuals who have your permission to pick up your child from Wesleyan Christian Academy. These individuals will be asked for ID.
Pick-Up Person 1
Relationship to the Student
Pick Up Person 2
Relationship to the Student

Acknowledgement of Understanding

Acknowledgement of Understanding(Required)
I have read and understand all of the information in Wesleyan’s After-School Program Registration form and I give my permission for my child to participate in the program. All of the information provided is correct and complete.

Further, I understand that participating in Wesleyan Christian Academy’s After-School Program is a privilege and requires that my child obey the After-School Care Teachers and the rules and regulations of the program. If my child fails to follow the rules, I understand that he/she may not be able to continue in the program.
By typing my name below I recognize and understand that the electronic signature below and any related fields will be treated by Wesleyan Christian Academy like a physical, handwritten signature on a paper form.
Wesleyan Christian Academy > Apply to Wesleyan > Continuous Enrollment > After School Program Registration

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1917 North Centennial Street,
High Point, NC 27262
Academy (336) 884-3333 Early Education Center (336) 884-3143
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