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Riverside Presbyterian Church After School Program

Enrollment Form

This form is required by all participants of the Riverside Presbyterian Church After School Program. If you have any questions, please contact Paul Kerchberger, The LeaderShop's Director of Programs & Operations, at

The monthly $375 Program Fee can be paid manually or set up as a recurring payment. Please select 'One Time' for the manual payment option or 'Monthy' for the recurring payment option based on your preference. If you select 'One Time' you will need to either submit payment via The LeaderShop's 'Make A Payment' tab on our website or write a check on the 1st of each month. An Annual Registration Fee of $20 is also required to reserve your spot in the program, which can be paid through The LeaderShop's Annual Registration Form. If you wish to pay by check please drop it off in the deposit box outside the Riverside Presbyterian Church Office Door.

Youth's Information


Parent's/Guardian's Information


Emergency Contact's Information