San Anto Cultural Arts After-School Enrollment Form
San Anto Cultural Arts’ After School Programming is BACK! 
Starting Monday, August 26th. For ages 8-18. 
Classes are in-person from Monday - Thursday from 4:00pm - 6:00pm.
*Students may be dropped off as early as 3:30pm.
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Student's First and Last Name *
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Age *
(If younger than 8 years old, student must be accompanied by an adult or older sibling.)
Ethnic Identity *
Student's Mailing Address *
(Address, City, State, Zip Code)
Student's School and School District *
(2024 - 2025)
Grade Level *
(2024 - 2025)
What class/classes are you most excited for? *
Required
Parent/Guardian 1 Name
 *
Parent/Guardian 1 Cell Phone Number
 *
Parent/Guardian 1 Email Address *
Parent/Guardian 2 Name
 *
(Anyone else who will be picking up the student)
Parent/Guardian 2 Cell Phone Number
 *
Number of Siblings *
Number of people under 18 living in home
 *
Check any that apply to you
Does anyone in your immediate family receive any of the following government assistance benefits?
SNAP
Medicaid
TNAF
CHIP
(check all that apply)
Does the student have any food allergies we should know about? *
(If none, put N/A)
How did you find out about SACA’s After-School Program?
 *
Is there anything else we should know about this student? *
(If no, put N/A)
Photo Consent (REQUIRED TO SUBMIT FORM)
 *
I hereby consent to the use by San Anto Cultural Arts, or anyone acting under its authority, including photographs, sketches, mural paintings, video, voice recordings, or other images to which this consent applies are the property of San Anto Cultural Arts and San Anto Cultural Arts shall have the right to duplicate, display, and make other uses of such images, free and clear of any claim whatsoever on my part. I further certify that I am a custodial parent, legal guardian or am the registered participant of legal age and have the aforementioned rights to assign.
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