• If not already on file: the child’s original birth certificate (for verification purposes only)
• If not already on file: a physical or well check, no older than 2 years, signed or stamped by physician (NEW ENROLLEES)
• If not already on file: immunization records, signed or stamped by physician (NEW ENROLLEES).
  • The following School Entrance Health Form can be used for your child’s health records; Part I is completed by a parent or guardian, Part II and Part III must be completed by the Medical Provider.
• Health Record Release Form If you have turned in your health records to your school they can make a copy for us upon completion of this form. Please submit to your school’s main office along with a copy of your driver’s license.

A $55.00 non-refundable registration fee (per child) and fees for the first month enrolled to attend are due at the time of sign-up. 

• Payment Methods: Check, Cash or Money Order only. Checks must be written in black or blue ink.
• FCCC does not hold payments or accept post-dated checks.

PAYMENT BOOK – not currently provided

PAYMENT ARRANGEMENT REQUEST FORM

FCCC only accepts checks, cash, or money orders.

For your taxes, our Tax ID# is 54-1590790.

For the 2020 tax year, since payment books were not available for you to track your payments, FCCC is waiving charges to print you an Annual Statement.  Complete and submit our Annual Statement Request Form and we will return your copy as requested.

Qualifying for a sliding scale tuition rate (Step 1, Step 2, or Step 3 fees) requires proof of your annual household income and completion of FCCC’s Income Verification Form. Your annual income includes all wages, child support, social security, etc. You will be charged full fee tuition until required documentation is received and verified.  The two most recent pay stubs for all household wage earners are required for proof of income.  If you have been approved for assistance through the DSS Daycare Assistance Program FCCC will need to see your verification letter from DSS.  To contact the Department of Social Services for assistance call (540) 422-8450.

If your child requires emergency medications the following forms must be on file along with the prescribed medication:

• MAT Form, 12-month
• (completed by parent, signed by doctor, valid for 12 months)
• Emergency Care Plan: Epi-pen (completed by parent, signed by doctor)
• Emergency Care Plan: Inhaler (completed by parent, signed by doctor)
• Short-term Medication Authorization Form (completed by parent, authorization not to exceed 10 days)
• Insect Repellant Authorization Form  (completed by parent, for daily insect repellant usage)

If your child has food allergies and will need an alternate snack the CACFP Special Dietary Prescription Form needs to be completed in its entirety for FCCC to remain in compliance with USDA regulations.

• CACFP Special Dietary Prescription Form

• 2020-2021 School Year Change of Care Form
• 2020-2021 School Year Change of Care Form, FCPS1 Employee

You will receive an eHandbook emailed to you after you complete the enrollment process. 

2020-2021 School Year eHandbook

Withdrawal from the program must be received, in writing, a full week prior to your child’s last date of attendance.

• Tuition is a weekly fee and is not prorated for withdrawal. If your withdrawal ends mid-week fees are due for the entire week.
• Once complete the following form can be taken to the FCCC center your child attends, e-mailed, or faxed to the Main Office at (540) 347-3518.

Withdrawal Form

COMING SOON!  Summer Camp calendars listing trips and activities will be posted once arrangements have been finalized.

• Bradley
• C. Hunter Ritchie 
• Grace Miller

• If not already on file: the child’s original birth certificate (for verification purposes only)
• If not already on file: a physical or well check, no older than 2 years, signed or stamped by physician (NEW ENROLLEES)
• If not already on file: immunization records, signed or stamped by physician (NEW ENROLLEES).
  • The following School Entrance Health Form can be used for your child’s health records; Part I is completed by a parent or guardian, Part II and Part III must be completed by the Medical Provider.
• Health Record Release Form If you have turned in your health records to your school they can make a copy for us upon completion of this form. Please submit to your school’s main office along with a copy of your driver’s license.

A $55.00 non-refundable registration fee is due, per child, at the time of sign-up.  Payment for the first week you child is enrolled is due on or before May 14, 2021.  REGISTRATION IS NOT COMPLETE UNTIL BOTH PAYMENS ARE RECEIVED.

• Payment Methods: Check, Cash or Money Order only. Checks must be written in black or blue ink.
• FCCC does not hold payments or accept post-dated checks.
• 2021 Summer Camp Tuition Chart

FCCC is no longer providing payment books.  Please make sure to write your child’s name on your check and what you are paying for on the memo line.

The following form can be used to set up a payment arrangement: Request for Payment Arrangement 

If your child requires emergency medications the following forms must be on file along with the prescribed medication:

• MAT Form, 12-month
• (completed by parent, signed by doctor, valid for 12 months)
• Emergency Care Plan: Epi-pen
  (completed by parent, signed by doctor)
• Emergency Care Plan: Inhaler
  (completed by parent, signed by doctor)
• Short-term Medication Authorization Form
  (completed by parent, authorization not to exceed 10 days)
• Insect Repellant Authorization Form 
  (completed by parent, for daily insect repellant usage)

If your child has food allergies and will need an alternate snack the USDA Special Diet Form needs to be completed in its entirety for FCCC to remain in compliance with USDA regulations.

• USDA Special Diet Form

Click on the link to our view our 2021 Summer Camp eHandbook.

Changes or cancellations from the FCCC Summer Camp program must be made, in writing, before 6:30PM, May 28, 2021. If changes or cancellations are not made by the deadline your account will be charged and fees will be due for the number of weeks marked on your Payment Agreement.

Camp Cancellation Form

• Complete and submit your cancellation at any FCCC location, including our Main Office, fax (540-347-3518) or e-mail (jessicapeil@fcccva.org).
• Parents will receive written confirmation of a withdrawal or cancellation.