CYC Aptos Beacon Center: School Year 2022-2023 After School Application and Registration Form
Dear Students and Families:

The CYC Aptos Beacon Center is pleased to offer our applications for the 2022-2023 school year! The Beacon Center’s after school program is designed in collaboration with the school and is in alignment with SFUSD guidelines. The program is open immediately after school and our daily schedule offers community building, academic/homework assistance, arts and recreation, enrichment classes, STEM exploration, leadership development, and many project based learning opportunities for students. In addition, CYC collaborates with other community based organizations and service providers who will provide programs and services during our after school program. Please note they may require additional registration requirements.

After School Program Hours:
Mondays, Tuesdays, Thursdays and Fridays: 4:00pm - 6:45pm*
Wednesdays: 2:15 - 6:15pm*
(*Times may change based on the next school year's bell schedule.)

Cost: Free (Due to the pandemic, CYC will not be charging fees until further notice.)

Program Acceptance Notifications: Program acceptance notifications will be sent out via email end of July or 1st week of August after our summer program. Due to our program's high interest, your child may be put on a waiting list if our program is full. Families MUST respond within 5 days of program acceptance; otherwise, the slot will be given to youth on the waiting list. We will email you a Class Activities Enrollment Form in August if your child is accepted into the program so they can select their after school class activities. Please feel free to contact us if you have any questions or concerns.

Contact Us: beacon@cycsf.org or call (628) 233-6356

We look to having your student in our program!
- CYC Aptos Beacon Team


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Email *
Student First Name: *
Student Last Name *
Student Email (if available)
Student Cell Phone (if available)
Date of Birth
MM
/
DD
/
YYYY
Grade in FALL 2022: *
Required
School Currently Attending: *
Home Address: (Please complete full address including state and zip code) *
City & State *
Required
Zip Code *
Required
Parent/Guardian First Name: *
Parent/Guardian Last Name: *
Relation to Minor: *
Parent/Guardian Phone Number: *
Parent/Guardian Email:
(Emergency Contact)  First Name *
(Emergency Contact) Last Name *
(Emergency Contact) Relationship to Minor *
(Emergency Contact)  Phone Number: *
END OF DAY ARRANGEMENTS FOR IN-PERSON PROGRAMS: Children must be picked up by program end time. Late pick up fee of $2 per minute if late. Please check all that apply: *
Required
By entering/signing name below, I verify that I consent for myself and/or my child to participate in virtual or in-person classes and activities offered by the Community Youth Center of SF. Furthermore, I understand that I or my child may be participating in an online platform utilizing video and audio chat with instructors as well as other program participants. I understand the classes maybe recorded and used for educational purposes. I understand foul images, audio, or chat will not be condoned and agree to follow community agreements and high standards of digital citizenship. (PLEASE TYPE IN NAME AS SIGNATURE IF YOU AGREE AND CONSENT. MUST BE ENTERED BY A PARENT/GUARDIAN IF YOU ARE UNDER 18 YEARS OLD.) *
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