201_2022-23-OnlineRegistration

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Best Prep at PS 201Q 2022 - 2023 Online Registration

Person completing registration form:

Relationship to child:

Student Information

Student's name:

Birthday:

Sex:

Male

Female

Grade [Grado]:

Any siblings attending BPA (Full name, Grade)?:

Home address:

Home phone:

Guardian Information

Parent/Guardian #1

Parent/Guardian #1 Full name:

Relationship to child:

Parent/Guardian #1 Cellphone:

Parent/Guardian #1 Work:

Parent /Guardian #1 Email address:

Parent/Guardian #2

Parent/Guardian #2 Full name:

Relationship to child:

Parent/Guardian #2 Cellphone:

Parent/Guardian #2 Work:

Parent /Guardian #2 Email address:

Emergency Information

Emergency contact name:

Emergency phone:

Emergency address:

Program details

My child is:

New to Best Prep

Returning student

Homework assistance + review
Dismissal - 5:30 PM
$335/ 4 weeks
Registration fee $60*
Waived for returning students

Dismissal Information

My child may be picked up by the following person(s):

My child may NOT be picked up by (mark as NA if unapplicable):

I give permission for my child to walk home alone at dismissal (Signature required):

Desired program start date (First day: 9/12/2022)

Student Health Information

Allergies (mark NA if not applicable):

Please check all that applies to your child:

Asthma

Behavorial/Emotional issues

Convulsions/Seizures

Diabetes

Corrective device (glasses, hearing aid, etc.)

N/A

Does your child take medication for any condition or illness? (Mark NA if not applicable):

Are there any activities your child can NOT participate in? (Mark as NA if not applicable):

For children who need Epinephrine auto-injector and/or inhaler on site:

I allow my child to carry his/her epi-pen and/or inhaler. (Signature required):

Program Policy

Please review Best Prep's Program Enrollment contract and policies by clicking the link below.

BPA policy

What is Adverse Childhood Experiences (ACEs)? Click on the link below to learn more.

Adverse Childhood Experiences (ACEs)

I have read and agree to the terms & conditions

Anything else you would like us to know?

Please review all information to make sure everything is accurate.

Please note registration is not finalized until payments are received.

You will not receive a confirmation after submitting the application from our website, but please wait for an email from one of our representatives.

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Best Prep at PS 201Q 2022 - 2023 Online Registration

Student Information

Guardian Information

Parent/Guardian #1

Parent/Guardian #2

Emergency Information

Program details

Homework assistance + review Dismissal - 5:30 PM $335/ 4 weeks Registration fee $60* Waived for returning students

Dismissal Information

Student Health Information

For children who need Epinephrine auto-injector and/or inhaler on site:

Program Policy

Please review Best Prep's Program Enrollment contract and policies by clicking the link below.

What is Adverse Childhood Experiences (ACEs)? Click on the link below to learn more.

*Please review all information to make sure everything is accurate. ** Please note registration is not finalized until payments are received. *** You will not receive a confirmation after submitting the application from our website, but please wait for an email from one of our representatives.

Homework assistance + review
Dismissal - 5:30 PM
$335/ 4 weeks
Registration fee $60*
Waived for returning students

Please review all information to make sure everything is accurate.

Please note registration is not finalized until payments are received.

You will not receive a confirmation after submitting the application from our website, but please wait for an email from one of our representatives.