The Isaiah Stewart Learning Center

God's Vision Afterschool Services

Our FREE program runs from October 21, 2024 to June 13, 2025, operating weekdays from 2:00 pm - 5:00 pm.

We are located at God's Visions Ministries, 694 Hudson Avenue, Rochester, NY 14621

Services Provided

Homework Support

Intervention / Enrichment

Hot Meals

Transportation

Registration Form

Isaiah Stewart Vision ALC

Register now to provide your child with enriching activities and support beyond school hours.

Don't miss out on this opportunity for growth and learning!

Student Name

Student ID#

Current School

Current Grade Level

Current Address

Street

City

State

Zip

Parent / Guardian Information

Parent/Guardian Name

Relation to Student

Home Phone

Cell Phone

Work Phone

Emergency Contact Information

Contact Name

Relation to Student

Phone

Transportation Information

Please be advised that transportation is only within City of Rochester Limits (Van Transportation Only)

Will transportation be required?

Pick up address

Is this location a school?

Drop off address

Medical Information

Doctor Name

Dentist Name

Does your child have allergies?

Yes, my child has allergies.

No, my child does not have allergies.

If so, what are they?

Does your child have seizures?

Yes, my child has seizures.

No, my child does not have seizures.

Does your child take medication(s)?

Yes, my child takes medication(s).

No, my child does not take medication(s).

Photo Release

Yes, I consent to the use of my child's name, photo, and/or video image for publicity purposes by God's Vision Ministries.

No, I do not want the use of my child's name, photo, and/or video image for publicity purposes by God's Vision Ministries.

Signature

Signature field is empty.

Date

Month

Day

Year