Click on Registration Form Below

CCLC Fillable Registration Forms - 2021-2022.pdf

SIGN UP! The Program begins on September 20, 2021

Use the link to the left to access the forms for registering your student for the After School Program this year.

In order to Register, you have a few options:

You will see a form link to the left on this page.

  1. The Registration Form link is a Fillable PDF. Download the form and complete it by filling in the required fields. Save it and attach it in an email to the Program Director, Tom Tatone, at In the email, type a message verifying the Registration form.

  1. The second option is to fill out the form in ink. Open the Registration Form and Print it. Fill it out in ink and have your child return it to their homeroom teacher. It can also be sent to Tom Tatone at DAHS, 988 N. Chestnut St. Ext., Derry PA 15627.

Other options:

  1. Parents may receive an email soon which will contain a printable or fillable pdf that can be completed and emailed back to the Program Director.

  1. Your child can obtain a Registration Packet from their Homeroom Teacher when they are at school. Complete it and turn it in as soon as possible.

Students cannot participate until the Packet is properly completed and turned in. The Program begins on Monday, September 20, 2021. Thanks for signing up!