#TPTB Tuesday After-School Program

This is a Tuesday faith-based after-school program for youth in grades 6 to 8, launching Tuesday, January 16th from 3pm to 5pm. It's a safe place for youth to unwind, eat pizza, play games, share in Christian fellowship, and receive homework help. It all happens at South Maple United Methodist Church located east of South Middle School at 202 East Indiana Street. Visit www.SouthMapleumc.org to learn more about our church! Enrollment is capped at 20 students and registration must be completed by January 9th, 2018.

* 1. Child's first and last name

* 2. Child's grade

* 3. Does Child have any medical conditions or allergies? If, so, please indicate below:

* 5. Are there custodial issues pertaining to your child? If yes, please explain.

* 6. First and Last Name of Parent/Guardian

* 7. Phone number

* 8. Email

* 9. Mailing Address