S.A.L.T. GRADES K-6TH

AN ECUMENICAL AFTER SCHOOL PROGRAM.

Click here for some notes about Salt

ALL THE FUN STUFF: FOOD, FAITH, SHARING, CRAFTS AND GAMES. We welcome a $30.00 contribution to offset the cost of supplies. thank you!

This semesters S.A.L.T. dates are Jan 16,23,30, Feb 6, 13,27, March 6,13,20,27, april 3,10, May 1,8,15,22,29 June 5, last S.a.l.t. June 12 3:15 TO 5:00 PM

No S.a.l.t. dates Feb. 20, Apr 17,24 June 19, 26.

Volunteers are welcome and appreciated - Please fill in dates on the registration form if you are available to help. Reach out to Jan if you have questions 631-765-2597 or text 516-617-2613.

Family Registration Form

Child(ren)'s Information: Full Name Date of Birth Grade School Allergies/concerns

Please enter above information for each child being registered.

Parent/Guardian's Name

First Name

Last Name

Mailing Address

Cell Phone

(###)

###

####

Email

In Case I cannot be reached please contact

Provide full name and phone numbers

I realize it is my responsibility to let program coordinators know if my child is to go home with someone other than a parent/guardian. In the event I do not my child has permission to get a ride home with the following people.

Please provide names of those with whom your child may get a ride.

Please indicate dates you are available to lend a hand.

Date(s) I can assist with SALT

Submitting this form is your signature. You may remit your contribution online thorough our giving portal, drop off at the church or mail to PO Box 787 Southold 11971. THANK YOU! Your contributions go directly to the SALT program.