The below individual(s) has/have completed registration for

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The below individual(s) has/have completed registration for Powered By Docstoc
					                            Children, Youth & Teen Programs
                           Newcomers Registration Cover Sheet


The below individual(s) has/have completed registration for enrollment into a Children,
Youth and Teen Program or Family Child Care home:

Sponsor: ______________________________

Child(ren)'s Name:                     Birthdate:              Age:       Program:

___________________________            _______________         _______    ___________________________

___________________________            _______________         _______    ___________________________

___________________________            _______________         _______    ___________________________

The following documentation is included in this registration package:
The below checked items must be included in the registration package.

Request for Care DD Form 2606         Emergency Contact                        
Newcomers Statement of Understanding          
Health & Special Needs Information


Other important Information:

IF USING CDC, CHILD(REN) CAN BE DROPPED OFF/PICKED UP AT BLDG. 499
___________________________________________________________________
IF USING SAC, CHIL(REN) CAN BE DROPPED OFF/PICKED UP AT BLDG. 1620
___________________________________________________________________
CHILD(REN) CAN BE DROPPED OFF AS EARLY AS 0645 AND PICKED BY 1645
___________________________________________________________________
PLEASE REMEMBER TO BRING A SACK LUNCH FOR YOUR SCHOOL AGE CHILD(REN)
___________________________________________________________________
Unit Sponsor must bring family in by Tuesday at 1200 prior to Newcomers
Brief_______________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
Unit Sponsor______________________

_____________________________                  __________________________________________
Parent's Signature & Date                      Clerk’s Signature & Date




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