CA Points Registration

Enrollment instructions

Only one child per family may be enrolled in the CA Points Program. Any individuals not listed on this form will not be added to any earned membership at the end of the school year. Changes are subject to fees. Please be sure to completely fill out all required information.

CA Points - Register

First Name of child being enrolled

Last Name of child being enrolled

Birthdate of child being enrolled

Student ID

Select a school on the program

First Name of Parent/Guardian

Last Name of Parent/Guardian

Parent/Guardian Birthdate

First Name of 2nd Parent/Guardian

Last Name of 2nd Parent/Guardian

2nd Parent/Guardian Birthdate

Phone

Does your family have a CA membership?

Yes

Enter your member number

Street Address

City

Zip

List brothers and sisters below who are age 22 or younger residing at the address above
All children listed (with their legal name) must be dependents as classified by the IRS and live at this address. Children with different last names will require a birth certificate at the time of receiving a membership card.

Sibling First Name

Sibling Last Name

Birthdate

Add Remove

Participation Permission

I authorize the school system to verify that my student meets the eligibility criteria for this program, if needed.

Signing this permission form does not guarantee your child a membership

I certify that I am a member of the child’s household (as defined in the FARMs application).

I understand and acknowledge that if my child participates in the CA Points Program, CA will receive the following information about my child, which will be used to determine my child’s continuing eligibility for the CA Points Program: name, address, FARMs enrollment status, school name, grades and attendance information. CA will not share this information with any other entity or program. However, because participation in the CA Points Program is limited to children enrolled in the FARMs program, I understand that my child may be identifiable as a FARMs program participant by virtue of their participation in the CA Points Program (including at CA Points Program events).

I agree to receive recurring automated promotional and personalized text messages from Columbia Association, Inc. (CA) regarding CA Points and other CA events, programming and memberships at the mobile number listed above. Reply STOP to opt out at any time. Message frequency varies. Message and data rates may apply.

Please Note: Once you click Submit, you will be directed to a HCPSS permission form which must be signed in order to complete your registration.

If you are human, leave this field blank.