For your child to participate in any CYSS program or activity on Carlisle Barracks, he/she must be registered through our central registration office, located in our Youth Services building; however, registration packets can be obtained at either the Youth Serivces (YS) building and/or the Moore Child Development Center (CDC).
Forms
Key to programs listed below - School Age Services (SAS), Middle School & Teen (MS & T), Moore Child Development Center (CDC).
.xfdl files may be opened with PureEdge Viewer and .pdf files may be opened with Adobe Acrobat Reader or similar programs.
Click on form number below to download the appropriate form.
| Form Name |
Form # |
Form Type |
Program Required for |
CDC Part Day Preshool application
|
133-R-E |
PDF
|
CDC
|
CDC Full Day Preschool application
|
755-R-E
|
XFDL |
CDC
|
| Family Culture/Information Form |
Infants
Pre-toddlers
Toddlers
Pre-school |
DOC
|
CDC
|
Child Development Services (CDS)
Registration Card |
DA 4719-R |
PDF |
CDC, SAS |
Child Development Services (CDS)
Child Health Assessment |
DA 5223-R |
PDF |
CDC
|
Army Child & Youth Services
Health Screening Tool |
DA 7625-1 |
XFDL |
CDC, SAS, MST |
Child Development Services (CDS)
Sponsor Consent Agreement |
DA 5222-R |
PDF |
CDC, SAS
|
Child Development Services (CDS)
Child And Family Profile |
DA 5224-R |
PDF |
CDC
|
Application for Department of
Defense Child Care Fees |
DD 2652 |
PDF |
CDC, SAS
|
| CYSS Youth Program & Sponsor Consent (Grades 6-12) |
cyss yprsc.pdf |
PDF |
|
Child Development Services (CDS)
Sponsor/Program Agreement |
DA 5226-R |
PDF |
CDC, SAS |
CYS Parent Permission / Agreement
Card for Internet Use |
DFMWR-CYS 32-R-E |
XFDL |
SAS
|
| Membership Application for Youth Services Carlisle Barracks |
DFMWR-CYSS 828-R-E |
PDF
|
SAS |
| Carlisle Barracks Youth Sports Registration |
DFMWR-CYSS 829-R-E |
PDF |
Youth Sports |
| Additional forms |
| Family Care Plan |
DA 5305-R |
PDF |
CDC, SAS
|
Child & Adult Care Food Program
Child Enrollment Form (one per child)
|
PA state form |
PDF |
CDC, SAS
|
Letter to Households: Child and
Adult Care Food Program |
PDE341
|
PDF |
CDC, SAS |
Single/Multi-Child Meal Benefit Application for Free & Reduced Price Meals (one per family)
|
USDA_PA
|
PDF |
CDC, SAS |
Fee Schedule
Army regulations require that fees will be determined based on a total family income (TFI) sliding scale. Patron supplies current LES or pay statement and child's shot records. Please click below to view applicable fees.
School year 2011 - 2012 Fee Chart
|
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