BSC/ASC Registration Form 2019-2020
Please complete this form and read through the 2019-2020 handbook. The $25 registration fee is payable by check or online. The registration fee and the form must be turned in prior to your use of the program.
Would you like to be added to the Remind Group for ASC to communicate emergencies, traffic, alternate rides, etc?
Yes, please add me.
No, thank you.
Child's First Name (you may list siblings with a comma separating their names)
Child's Last Name
Child's Date of Birth:
Allergies and Medical Needs
Please list any know allergies and/or include any special needs
If registering more than one child, please include names with each:
Please select your BSC/ASC plan
*Please note, Full-time ASC includes BSC at no extra cost*
10-day Flex ASC
Corvian Staff Credit
Parent 1 Name:
Parent 1 Email:
Parent 1 Phone Number:
Parent 2 Name:
Parent 2 Email:
Parent 2 Phone Number:
Please list anyone approved to sign out your child
Emergency Contact 1 Name:
Emergency Contact 1 Phone Number:
Emergency Contact 2 Name:
Emergency Contact 2 Phone Number:
Please affirm you have read the 2019-2020 BSC/ASC Handbook
I have read and understand the BSC/ASC Handbook
Send me a copy of my responses.
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