CCCS Co-op 2025/26 Application

Mother's Name

Father's Name

Address *

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Mobile Phone *

Child Name, Gender, Birthday, and Grade *

Child Name, Gender, Birthday, and Grade

Please list any adults that may bring your children to co-op along with their phone number.

Please list an emergency contact with phone number *

Is your family a part of another co-op? Please list below.

Who do you file your homeschool affidavit with? IE: PSP/Umbrella School, Charter, Independent *

Does your child have any allergies? *

Does your child have any medical challenges that we should be aware of?

Is there anything else you would like us to know in order to care for your children better while they are on campus?

Statement of Faith

What church does your family attend?

Printed Mother Name *

Signature *common.clear

Date *

Printed Father Name

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Date

Guidelines and Policies

Printed Mother Name *

Signature *common.clear

Date *

Printed Father Name

Signaturecommon.clear

Date

2025/26 Classes

Child's Name

First Hour Classes

Second Hour Classes

Child's Name

First Hour Classes

Second Hour Classes

Child's Name

First Hour Classes

Second Hour Classes

Child's Name

First Hour Classes

Second Hour Classes

Child's Name

First Hour Classes

Second Hour Classes

Child's Name

First Hour Classes

Second Hour Classes

List all children's names that you are giving permission for the photo and video release *

Printed Parent Name *

Signature *common.clear

Date *

Names of Children for Release of Liability *

Printed Mother Name *

Signature *common.clear

Date *

Printed Father Name

Signaturecommon.clear

Date

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CCCS Co-op 2025/26 Application

Statement of Faith

Guidelines and Policies

2025/26 Classes