BCA/WPS Summer School/Camp Registration Form
We welcome students entering Pre-K through 5th grade to our BCA Summer School and 6th through 8th grade to our WPS Summer Camp!
Please fill out a form for each individual student.

BCA/WPS Summer School/Camp information can be found on our websites.

★ Bellevue Children's Academy (Pre-K - 5th):
www.bcacademy.com | summer@bcacademy.com
★ Willows Preparatory School (6th - 8th):
www.willowsprep.com | summer@willowsprep.com

- Main Phone Number: 425-649-0791

★ Bilingual Summer School (Pre-K - 5th)
www.bcasaturdayschool.com | saturdayschool@bcacademy.com
425-785-8032

# Please complete an ACH form within 3 days if you are a non-BCA/WPS family or wish to change your bank information for withdrawals. ACH form can be downloaded from BCA or WPS websites.

Email address *
Student's Name *
Your answer
Student's Gender *
Name of the school (Fall 2017) *
Please complete the ACH form to set up the payment process if you are a non-BCA/WPS family. ACH form can be downloaded from BCA/WPS websites.
Parent's Name *
Your answer
Contact Phone # *
Your answer
Address *
Your answer
Emergency Contact Phone # *
Your answer
Does your child have any allergies? *
-- If yes, please list below
Your answer
Photo/Video Release Authorization *
Student's Grade (Fall 2017) *
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