SACC Pre-Registration 2021-2022
**A non-refundable $40.00 registration fee is due at time of registration.**
In the event that your child obtains a spot within the SACC program, a complete registration packet (a different google form), emergency card, physical (good for 2 years) & up-to-date immunization record must be completed & turned in at time of offer. This is done for every child EVERY school year. All paperwork MUST be submitted prior to their first day of attendance.
Child's name *
Male or Female *
Child's Age *
Grade Fall 2021-22 *
Care Needed *
Sibling(s) attending SACC? (You must complete a separate form for each child) *
Name(s) of siblings attending SACC. If none, type NA. *
Indicate any medial concerns or special needs your child requires that we need to be aware of such as medications, allergies, health conditions, behavior challenges, aides, etc. *
Email address for paperwork to be sent when a spot in the program becomes available: *
Parent #1: Name *
Parent #1: Cell Phone Number *
Parent #1: Work Phone Number *
Parent #1: Address (full address please) *
Parent #1: Email Address *
Parent #2 Name *
Parent #2 Cell Phone Number *
Parent #2: Work Phone Number *
Parent #2 Address (Full address please) *
Parent #2: Email Address *
This serves as your signature. Please type your full name. *
Today's Date is: *
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