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ENROLLMENT FORM - Our Kids First Application:

Check One


Summer Program
First Name
Last Name
DOB
Grade
School
Parents / Legal Guardians
Address
City
Zip Code
Day Phone
Work Phone
Cell Phone
E-mail
Alt. Emergency Contact
Name and Phone
Insurance Company
Policy #
List ALL Existing Medical: Conditions (allergies/medications)

In order for Our Kids First (OKF) to apply for foundation and individual support to underwrite our programs and keep costs a t a minimum, we ask that you please respond to the following demographic information. This information is optional and confidential. We appreciate your assistance.

Ethnicity of Youth: (Please check all that apply or type your response)
African American
Asian
Latin/Hispanic
Multi Ethnic
Non-White
Pacific Islander
Native/American Indian
White
Other

Income Level: (Please select your annual household income)
Less than $30,000
$30,001-$40,000
$40,001-$55,000
$55,001-$ 75,000
over $75,001
   
 

 

    
This program is supported by the following: DCYF (Department of Children, Youth and Their Families)
SFCC (San Francisco Christian Center) | Computer lab grant provided by AT&T
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