After School Program 2020 Application  

We are excited to bring a virtual after school program for the 2020-2021 school year! Music, art, cooking, and other special events will be offered on a monthly basis throughout the school year! Please note that these programs will be given over via zoom so access to internet and a computer or tablet is needed. 

Start date: November 2020-May 2021  


Time: 3:30pm-5pm


Place: Zoom 


Age: Participants must be between 9-17 years old.

*Please contact us if child is outside age group and wishes to join!

Cost: This is a free program 


Specific schedule:

Music: 3:30pm-4:30pm the first Tuesday of every month starting November 3, 2020-May 4, 2021

Art: 3:30pm-5pm the second Tuesday of every month starting November 10, 2020- May 11, 2021 

Cooking: 3:30pm-5pm the third Thursday of every month starting November 19, 2020- May 20, 2021 

Special events: 3:30pm-4:30pm the last Tuesday of every month starting November 24th, 2020-May 25, 2021


If you have any additional questions please contact miriam@epilepsynorcal.org.


Child General Information 


Emergency Contact Information

General Health 


Informed Consent and Acknowledgement