Busy Bee Registration for 2022-2023
Use this form to register your child/children for the Busy Bee after school program.  Filling out this form does not guarantee your child a spot in our program.  You will be contacted if your child is accepted.  You must pay the registration fee AND first week's payment AND there must be a spot open at that particular grade level.  All students not accepted will be put on a wait list according to their time and day they signed up.  All information is on the website.  
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Student 1 *
Student 1 grade for 22-23 *
Required
Student 2
Student 2 grade for 22-23
Student 3
Student 3 grade for 22-23
Student 4
Student 4 grade for 22-23
Parent/guardian 1 *
Parent/guardian 1 phone *
Parent/guardian 2
Parent/guardian 2 phone
Email address 1 *
Email address 2
Home address *
Days children will attend (this must be consistent each week) *
Required
Emergency contact 1 *
Phone Contact 1 *
Relationship to student *
Emergency contact 2
Phone Contact 2
Relationship to students
student 1 does your child have allergies, if yes, what are they? *
student 2 does your child have allergies
student 3 does your child have allergies, if yes, what are they?
student 4 does your child have allergies, if yes, what are they?
Student 1 - Does your child have other medical needs we should know about, if yes what are they? *
Student 2 - Does your child have other medical needs we need to know about, if yes what are they?
Student 3 - Does your child have other medical needs we need to know about, if yes what are they?
Student 4 - Does your child have other medical needs we need to know about, if yes what are they?
My child/children should complete homework as follows *
There are times during which your student may be in a photograph or digital video that will be part of promotional materials associated with the Busy Bees after school program.  Please choose one of the options below: *
As an incentive, there may be times when your child will be viewing a G or PG movie. Please check below to approve or decline movie ratings for your child.  (check all that apply). *
Required
I have read the Busy Bee disclaimer page on the website and understand the payment and behavior policies associated with attending this program. *
Name of person submitting the form (this will serve as your electronic signature and acknowledgment of the disclaimer above). *
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