Y-Zone: YMCA After School Program

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* 1. If an after school program facilitated by the Clinton YMCA was held at Schneider Elementary for grades K-5 starting on January 5 from 2:20-5:45 p.m. Tuesday-Friday, would you be interested in sending your child/children at the cost of $12.50 for each child per day.

Yes

No- If you answer no, please skip questions 2-4 and select the "Done" button.

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* 2. Which days would you be interested in sending your child/children? Please check all that apply:

Tuesday

Wednesday

Thursday

Friday

Interested in program, but can't commit to specific days at this time.

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* 3. How many children would you send to Y-Zone in grades K-5:

1

2

3

4

5 or more

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* 4. What grades are your children enrolled in that would be attending? Please check all that apply:

Kindergarten

First Grade

Second Grade

Third Grade

Fourth Grade

5th Grade