CLASS REGISTRATION FORM

Please fill out this form fully. You may put siblings on the same form, but please be sure to identify ages and classes for each.
Thanks!

STUDENT AND CLASS INFORMATION

Student First Name(s)

Student Last Name

Student Age(s) and Preferred Pronouns

Class(es) Registered

PARENT/GUARDIAN CONTACT INFORMATION

Parents/Guardians Full Names

Email(s)

Phone Number(s)

Street Address

City

State

Zip code

EMERGENCY CONTACT / MEDICAL INFORMATION & RELEASE
Please add a contact other than a parent - we will always try parents first

Alternative/Emergency Contact Name and Phone Number

Please list any medications, allergies, behavior plans or other necessary / helpful information about your child:

I understand that teachers sometimes take students outside to the garden or to downtown locations within walking distance. Each class will have at least one extra assistant during these times. I give permission for my child to go with the class on these field trips.

Yes, I give permission

No, my child may not accompany the class on field trips and will stay behind with the SAAC staff member present.

I understand that photos of kiddos engaged in dynamic learning are important for SAAC to use when applying for grants, seeking funding and promoting classes. I give permission for photographs that include my child to be used on the SAAC website, in SAAC social media and for SAAC grant applications.

Yes, I give permission

No, my child may not be included in photographs for promotional or nonprofit funding purposes

If you paid online and the name on the credit card used for payment is the not the name given for Parent/Guardian above, please list that name here so we will know this class is paid for and registration is complete.

Thank you for registering! We look forward to your class!

CLASS REGISTRATION FORM

Please fill out this form fully. You may put siblings on the same form, but please be sure to identify ages and classes for each. Thanks!

STUDENT AND CLASS INFORMATION

PARENT/GUARDIAN CONTACT INFORMATION

EMERGENCY CONTACT / MEDICAL INFORMATION & RELEASE Please add a contact other than a parent - we will always try parents first

Please fill out this form fully. You may put siblings on the same form, but please be sure to identify ages and classes for each.
Thanks!

EMERGENCY CONTACT / MEDICAL INFORMATION & RELEASE
Please add a contact other than a parent - we will always try parents first