BASC Survey for 2020-2021 School Year
Student Last Name
Student First Name
Age of Student
Please share any information about your child that would be helpful for us in our planning process
Elementary School Attending
Stony Point Elementary
Sugar Loaf Elementary
Relationship to Child
Parent/Guardian Phone Number
Did your child attend BASC during the 2019-2020 school year?
Will you need childcare for the 2020-2021 school year?
Please indicate when you will need care.
Both AM and PM care
Will your child attend school on the A schedule (Mon & Tues) or the B schedule (Thurs & Fri)?
Will you have a working phone number and a secondary contact number in the event your child becomes ill while in our care?
I understand that the BASC program will follow the same guidelines as the regular school day regarding social distancing, the wearing of masks, handwashing and other guidelines deemed necessary for the health and safety of students and staff.
Do you want to be emailed an enrollment form for childcare so you can register now paying the $25.00 registration fee? The enrollment form can be dropped off at your school or it can be mailed.
Yes, email me the enrollment form and I will return via mail.
Yes, email me the enrollment form and I will drop it off at my school site.
No, I will register on August 10th by enrolling at my school site from 2-5 pm at the BASC site.
If you have any questions or need additional information, you may email
You may also contact the office at your school to get contact information for your site coordinator if needed. This is not an enrollment form. Students who were enrolled last year in the BASC program will get priority. The enrollment form is required to enroll your child.
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This form was created inside of Alexander County Schools.