COVID Vaccination Interest Form
If there is enough interest, Crescent Academy will partner with Rite Aid Pharmacy to provide no-cost COVID vaccinations for adults and children 12 and up June 24th and June 25th at the Middle School Campus (CTAB).

Please complete the form below by Friday, June 11th and someone will follow up with you with more information.
Name: *
I'm interested in receiving the COVID vaccination for myself. *
I'm interested in my child/children receiving the COVID vaccination. *
If you answered yes to the question above, provide their names in the space provided below.
Family member(s) or friends are interesting in receiving the COVID vaccination. *
If you answered yes to the answer above, provide their name(s) and phone number(s) below.
Best contact number: *
Submit
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