Application.

Student Information

Student First NameLast NameDate of BirthStudent Home AddressAddress Line 1Address Line 2CityStateZip CodeCountryUnited StatesUnited States (US)What school(s) does your student attend?Student Grade– Select grade –Kindergarten1st grade2nd grade3rd grade4th grade5th grade6th grade7th grade8th grade9th grade10th grade11th grade12th gradeTshirt Size– Select size –Youth SmallYouth MediumYouth LargeYouth XLShoe Size

Parent’s Information

Parent First NameLast NameParent’s EmailParent’s Phone NumberI’m interested in my son or daughter attending the afterschool program at the Overtown Optimist Club. Yes NoWill your son or daughter be able to attend afterschool programming, at least 4 days per week? Students not attending programming twice weekly risk suspension from program. Yes NoThe Optimist Club provides transportation for our close neighboring schools (Frederick Douglass, Phillis Wheatley, Paul Dunbar K-8, Downtown Miami Charter School). Does your student require a pickup from school to afterschool programming? Yes, I will need a school pick-up. No, I do not require transportation. My student can walk. Submit Form