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Summer 2023 Registration Form
Please complete all required fields to register your child for Summer SACC!
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* Indicates required question
Email
*
Your email
Parent/Guardian Phone Number
*
Your answer
Is your child(ren) currently enrolled in a SACC program?
*
Yes
No
Which summer program will your child(ren) attend?
*
Choose
Raymond (Jordan Small Middle School location)
Windham (Field Allen Portable Classrooms location)
Which day/s would you like to enroll your child(ren)? Please note, consistent registration week to week for all 9 weeks is required.
*
Monday
Tuesday
Wednesday
Thursday
Friday
Required
Child's First and Last Name (#1)
*
Your answer
Birthday
*
MM
/
DD
/
YYYY
Age
*
Your answer
Gender
*
Your answer
Incoming Grade
*
Your answer
Home Address
*
Your answer
Child's First and Last Name (#2)
Your answer
Birthday
MM
/
DD
/
YYYY
Age
Your answer
Gender
Your answer
Incoming Grade
Your answer
Home Address
Your answer
Child's First and Last Name (#3)
Your answer
Birthday
MM
/
DD
/
YYYY
Age
Your answer
Gender
Your answer
Incoming Grade
Your answer
Home Address (Street, City, Zip Code)
Your answer
Activity fee of $100 is due at time of registration. Please indicate your method of payment.
*
Choose
Mail check to PO Box 839, Windham ME, 04062
Drop off payment at one of our locations (please reach out via email to director@windhamraymondsacc.com to coordinate payment drop off)
Pay via ProCare on your account @ myprocare.com
Is there any other information you'd like us to know at this time?
Your answer
A copy of your responses will be emailed to the address you provided.
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