SBC CDC In-Person Afterschool Care & Summer Camp Program 
Please complete this form to register your child for SBC CDC afterschool care and summer camp for kindergarten - seventh grade students partly funded by The Children's Trust. A separate google docs registration form and a Children's Trust form has to be completed for each child you register. No per diems. You are charged monthly for weekly fees regardless if your child is absent on days during the service period. 
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Email *
We are a proud Children's Trust funded program.  
Please note that The Children's Trust may contact you via postal mail, email and/or text to ask about your satisfaction with services, and to make you aware of other Trust-funded programs, initiatives and events that may interest you.
Child/Youth Last Name: *
Child/Youth First Name: *
Child/Youth Middle Name: *
Child/Youth's Date of Birth *
MM
/
DD
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YYYY
Child/Youth Gender *
Mailing Address (Including Apt, Unit, Suite, etc.) : *
City *
State *
Zip Code: *
Caregiver Last Name *
Caregiver First Name *
Caregiver Phone Number (XXX-XXX-XXXX): *
Is the above phone number a cell/mobile phone?  *
Caregiver Email Address (for invoices and notifications)
Caregiver preferred language for contact (Please select only one): *
Youth Phone Number
Is the above phone number a cell/mobile phone? 
Clear selection
Youth Email Address
Child'/Youth's 2024-2025 Current Grade Level *
Miami-Dade County Public Schools ID# *
Child/Youth's Current School: *
What is the child/youth's preferred language for contact? *
Required
What language(s) does the child/youth feel comfortable communicating in? Select all that apply.  *
Required
Child/Youth Ethnicity *
Child's Race (select only one) *
Does the child have health insurance (ex. private, Kidcare, or Medicaid)? *
Please list any allergies:
Is your child on free or reduced lunch? *
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