2016-2017 BSC New Family Registration Form
Before-School Care (BSC) is preparing for the 2016-2017 school year. As Collegium’s enrollment numbers continue to increase, we anticipate a very strong interest in the BSC program. Please complete/submit this form and send the appropriate fees as outlined below. New family BSC registration begins Saturday, April 30th and ends Friday, May 13th.

In order to register your child(ren)for the 2016-2017 BSC program, please do the following:
#1. Complete the form below by Friday, May 13th.
#2. Pay the non-refundable registration fee ($30.00 per child or $50.00 per family).
#3. Pay weekly care fees for the first and last week of 2016-2017 BSC ($70.00 per child).

Please submit fees to the attention of Ms. Horsey, 535 James Hance Court, Exton, PA 19341. Fees must be submitted in a sealed envelope with the BSC student(s) first and last names indicated on the front. Fees must be paid-in-full by Friday, May 13th. If you do not complete the form below and submit the required fees as outlined above by Friday, May 13th, a space for your child(ren) will not be held.

The 2016-2017 BSC registration fee is non-refundable. Weekly care fees for 2016-2017 will be $35.00 per week per child regardless of the number of days your child(ren) attends. Additionally, weekly care fees will be adjusted for the few weeks during the school year that Collegium is only in session for a partial week (ex. Thanksgiving week). Weekly care fees are not adjusted for weather-related delays or closings.

Confirmation of BSC registration will be provided via email. Once registration is confirmed, the weekly care fees are non-refundable unless Collegium is able to fill your child’s space in the program with another student. If we cannot fill the space, the weekly care fees will not be refunded.

Questions? Please contact Ms. Horsey (lhorsey@ccs.us).

Child's First Name
Please list the first name of the child you want to registered in the BSC program.
Your answer
Child's Middle Name
Please list the middle name of the child you want to registered in the BSC program.
Your answer
Child's Last Name
Please list the last name of the child you want to registered in the BSC program.
Your answer
Child's Date of Birth
MM
/
DD
/
YYYY
Child's 2016-2017 Grade Level
Remember, 2016-2017 begins in August 2016.
Child's Medical Alerts
If medical alerts do not exist, please select "N/A". If medical alerts exist, please describe in "Other". In the event of an emergency, every effort will be made to notify parents/guardians. If necessary, a child(ren) will be transported to the closest medical facility by emergency vehicle. We will continue to attempt to notify parents/guardians when possible.
Child's Allergies
If allergies are not known, please select "N/A". If known allergies exist, please describe in "Other". In the event of an emergency, every effort will be made to notify parents/guardians. If necessary, a child(ren) will be transported to the closest medical facility by emergency vehicle. We will continue to attempt to notify parents/guardians with possible.
Child's Dietary Restrictions
If dietary restrictions are not applicable, please select "N/A". If dietary restrictions exist, please describe in "Other". In the event of an emergency, every effort will be made to notify parents/guardians. If necessary, a child(ren) will be transported to the closest medical facility by emergency vehicle. We will continue to attempt to notify parents/guardians with possible.
Child's Street Address
Your answer
Child's City
Your answer
Child's Zip Code
Your answer
Parent/Guardian #1 First Name
Your answer
Parent/Guardian #1 Last Name
Your answer
Parent/Guardian #1 Home Phone Number
Please provide phone number as XXX-XXX-XXXX. If you do not have a Home Phone Number, please write "N/A".
Your answer
Parent/Guardian #1 Cell Phone Number
Please provide phone number as XXX-XXX-XXXX. If you do not have a Cell Phone Number, please write "N/A".
Your answer
Parent/Guardian #1 Work Phone Number
Please provide phone number as XXX-XXX-XXXX. If you do not have a Work Phone Number, please write "N/A".
Your answer
Parent/Guardian #1 Primary Email Address
BSC registration confirmation is provided via email message. Please provide your primary email address below to receive registration confirmation and any additional information related to the BSC program.
Your answer
Parent/Guardian #2 First Name
Your answer
Parent/Guardian #2 Last Name
Your answer
Parent/Guardian #2 Home Phone Number
Please provide phone number as XXX-XXX-XXXX. If you do not have a Home Phone Number, please write "N/A".
Your answer
Parent/Guardian #2 Cell Phone Number
Please provide phone number as XXX-XXX-XXXX. If you do not have a Cell Phone Number, please write "N/A".
Your answer
Parent/Guardian #2 Work Phone Number
Please provide phone number as XXX-XXX-XXXX. If you do not have a Work Phone Number, please write "N/A".
Your answer
Parent/Guardian #2 Primary Email Address
Your answer
Need To Register a Sibling for 2016-2017?
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