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.
Email address *
Would you like to be added to the Remind Group for ASC to communicate emergencies, traffic, alternate rides, etc?
*
Required
Student Information
Child's First Name (you may list siblings with a comma separating their names) *
Your answer
Child's Last Name *
Your answer
Child's Date of Birth: *
MM
/
DD
/
YYYY
Grade: *
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:
Your answer
Please select your BSC/ASC plan
*Please note, Full-time ASC includes BSC at no extra cost*
*
Contact Information
Parent 1 Name: *
Your answer
Parent 1 Email: *
Your answer
Parent 1 Phone Number: *
Your answer
Parent 2 Name:
Your answer
Parent 2 Email:
Your answer
Parent 2 Phone Number:
Your answer
Please list anyone approved to sign out your child
Emergency Contact 1 Name: *
Your answer
Emergency Contact 1 Phone Number: *
Your answer
Emergency Contact 2 Name:
Your answer
Emergency Contact 2 Phone Number:
Your answer
Please affirm you have read the 2019-2020 BSC/ASC Handbook
*
Required
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