2024-25 Intent to Enroll Lebanon YMCA SACC Program
This form is for the fall of 2024-25 School Year. By completing this form, it does not guarantee you space into our program. You will receive an email from childcare@lebanonymca.org, confirming your spot in our program. Please take 2 minutes and complete the form below.
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Email *
Parent First and Last Name *
Child's First Name
 *
Child's Last Name
 *
Street Address
 *
City, State and Zip
 *
Best Contact Number
Child's Date of Birth
MM
/
DD
/
YYYY
Gender
Clear selection
Elementary School
*
Grade in Fall of 2024-25
 *
I would like care for: *
I plan to pay: *
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