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| The following forms must be filled out and turned into the central registration office at the Child & Youth Services Building #847 | ||
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Attachment A & B |
Child Social Security Form | |
| Fee Categories for CYS |
DA-1917
Immunization and Registration Information |
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DA-5222 Answer questions, sign and date. |
DA - 5226
CDS Sponsor/Program Agreement Form |
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DA-4719
Fill out the front completely making sure you write home and duty phone numbers. On the Emergency Notification Designee you need to put someone OTHER than the parents. The same name should go on the Child Release Designee. On the back, write name of child, birth date, and sex. At the bottom, write parent's name, child's name, date, and sign. |
DA-5224
Answer questions front and back. Any questions that do not apply to your child, you may write N/A. On the Contingency Care Plan for Child Illness, you may say something like “Parents will care for sick child.” On the emergency Notification Designee, you may write the same person that you did on DA-4719. If you do not know 2 other people for emergency designees, we will give you a suspense of thirty days. |
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DA-5223
Answer the questions front and back. Make an appointment to take your child to your family doctor. Take this form so that your doctor can answer questions on the back. The doctor will need to complete a physical on the child and then sign and date the reverse of this form. You then also sign and date the form. A 30 day suspense will be given if you cannot get an appointment prior to your registration appointment. |
DA-2652
Answer questions 1-13 on the Income Verification. There are instructions in Section II that will tell you what to include in your annual income. We will also need you to furnish an LES and/or pay stubs with the paperwork for your file. |
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ALL PAPERWORK MUST BE COMPLETED AND THE PARENT HAS ATTENDED AN ORIENTATION BEFORE YOUR YOUTH CAN USE THE YOUTH SERVICES PROGRAM. Your child is NOT registered, nor can they be placed on a Wait List until all the forms have been completed, turned in to Central Registration, the file has been approved, and the Registration Fee paid. |
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