[City of Santa Barbara] Summer FUN Priority Registration

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THIS IS NOT REGISTRATION FOR THE SUMMER FUN PROGRAM.

BY FILLING OUT THIS FORM, WE ARE VERIFYING THAT YOU QUALIFY FOR PRIORITY REGISTRATION AND IT DOES NOT GUARANTEE YOUR CHILD WILL GET INTO THE PROGRAM.

What you will need to register:

1.) A PerfectMind Account. If you don't have one, click here to create one.

2.) Amend your child's medical information in PerfectMind. Don't know how? Click here to see instructions.

3.) Complete this form.

4.) Check your email, register and pay by April 21, 2022.

*Paying the $25 fee is your confirmation that you are registered in the Summer Fun Program.

I verify that I have already created my account in PerfectMind.com. If you have NOT created your account, please STOP and visit PerfectMind.com here: https://cityofsantabarbara.perfectmind.com/SocialSite/MemberRegistration/MemberSignIn

Yes, I've already created my PerfectMind account!

No, I don't have an account.

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The 2021 Summer FUN Program will be taking priority registration April 19 - April 23. In order to be given priority you must complete this document.

Priority registration is given to families who receive financial assistance. Please upload a copy of one of the following:

CalFresh (Supplemental Nutrition Assistance Program)
WIC (Women, Infants, and Children Nutrition Services)
SSI (Supplemental Security Income)
TANF (Temporary Assistance for Needy Families)
SSDI (Social Security Disability Insurance)
Medi-Cal

*PLEASE NOTE: The individual(s) receiving assistance must either be the guardian of, or the child(ren) being registered for the Summer FUN Program

Upload File(s)

Click Here to Upload

Phone Number (xxx-xxx-xxxx)

Child 1

First and Last Name *

Date of Birth (00/00/0000) *

School Name *

Child 1- Grade in 2022 School Year

Child 2

First and Last Name

Date of Birth (00/00/0000)

School Name

Child 2- Grade in 2022 School Year

Child 3

First and Last Name

Date of Birth (00/00/0000)

School Name

Child 3- Grade in 2022 School Year

Child 4

First and Last Name

Date of Birth (00/00/0000)

School Name

Child 4- Grade in 2022 School Year

Questionaire

This year, the Parks and Recreation Summer Fun Program will be offered at Franklin Elementary School. At the moment, this is the only available site. Please select Franklin and continue to the next question.

Franklin Elementary School

If accepted into the Summer Fun Program, I understand that I will need to pay a $25 (non-refundable) fee per child by April 21, 2022.

Yes

I understand that participants are required to attend a minimum of 3 days a week for the duration of the program. Will your child(ren) attend a minimum of 3 days a week beginning June 14-August 6?

Yes

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Last Name

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I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.