Editing previous response:

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SACP Summer Care Student Registration

Student Information

Legal First Name*

Answer required for "Legal First Name"

Legal Middle Name

Answer required for "Legal Middle Name"

Legal Last Name*

Answer required for "Legal Last Name"

Preferred Name

Answer required for "Preferred Name"

Grade Entering*

Answer required for "Grade Entering"

Date of Birth*

Answer required for "Date of Birth"

First Language Spoken by Student*

Answer required for "First Language Spoken by Student"

Languages Spoken at Home*

Answer required for "Languages Spoken at Home"

Address

Street Address*

Answer required for "Street Address"

City*

Answer required for "City"

Zip/Postal*

Answer required for "Zip/Postal"

Home Phone*

Number Required

Parent 1 Information

First Name*

Answer required for "First Name"

Middle Name

Answer required for "Middle Name"

Last Name*

Answer required for "Last Name"

Email*

Answer required for "Email"

Mobile Phone*

Number Required

Work Phone

Number Required

Parent 2 Information

First Name*

Answer required for "First Name"

Middle Name

Answer required for "Middle Name"

Last Name*

Answer required for "Last Name"

Email*

Answer required for "Email"

Mobile Phone*

Number Required

Work Phone

Number Required

Emergency Contact Information

First Name*

Answer required for "First Name"

Middle Name

Answer required for "Middle Name"

Last Name*

Answer required for "Last Name"

Relationship to Student*

Answer required for "Relationship to Student"

Email*

Answer required for "Email"

Phone*

Number Required

First Name*

Answer required for "First Name"

Middle Name

Answer required for "Middle Name"

Last Name*

Answer required for "Last Name"

Relationship to Student*

Answer required for "Relationship to Student"

Email*

Answer required for "Email"

Phone*

Number Required

First Name

Answer required for "First Name"

Middle Name

Answer required for "Middle Name"

Last Name

Answer required for "Last Name"

Answer required for "Email"

Phone

Number Required

Please list anyone who is NOT authorized to pickup your child. *

Answer required for "Please list anyone who is NOT authorized to pickup your child. "

Family Doctor Information

Name*

Answer required for "Name"

Phone*

Number Required

Please list any allergies. *

Answer required for "Please list any allergies. "

Please list any medical concerns the SACP staff should be aware of.*

Answer required for "Please list any medical concerns the SACP staff should be aware of."

Can your child be photographed for social media, local media, and website?*

Answer required for "Can your child be photographed for social media, local media, and website?"

Yes

Signature*

Signature Required

Confirmation Email

Confirmation Email *

Answer required for "Confirmation Email"