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Best Prep After School at PS 154Q
Online Registration Form (2023-2024)
Student Information
Student's last name
Student's first name
Birthday
Sex
Male
Female
GRADE
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5TH GRADE
Class (if known)
Home address
My child is:
New to Best Prep
Returning student
Any siblings attending BPA (Full name, Grade)?
guardian Information
PARENT/GUARDIAN #1
Parent/Guardian #1 Full name
Relationship to child:
Parent/Guardian #1 Cell:
Parent/Guardian #1 Work:
Parent /Guardian #1 Email address
PARENT/GUARDIAN #2
Parent/Guardian #2 Full name
Relationship to child:
Parent/Guardian #2 Cell:
Parent/Guardian #2 Work:
Parent /Guardian #2 Email address
EMERGENCY CONTACT
Emergency contact name:
Emergency phone
Emergency address
SAME A HOME
program details
PROGRAM INFORMATION
MONDAY - FRIDAY
2:15 - 5:30 PM
$60 REGISTRATION FEE
10% SIBLING DISCOUNT
PROGRAM SELECTION
3:30 Dismissal ($195)
5:30 Dismissal ($395)
Payment method preference
Zelle
Check
Credit card (3.837% fee applies)
Cash
Desired Start Date (Program start TBD)
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)
Clear
student's 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 students who need Epinephrine Auto-Injector (EPIPEN) and/or inhaler on site:
I allow my child to carry his/her epi-pen and/or inhaler. (Signature required):
Clear
PROGRAM POLICY
ENROLLMENT CONTRACT
Please review Best Prep's
Program Enrollment contract and policies
by clicking the link below.
Best Prep policy
I have read and agree to the terms & conditions
Adverse Childhood Experiences (ACES)
What is Adverse Childhood Experiences (ACEs)?
Learn more by clicking the link below.
Adverse Childhood Experiences (ACEs)
Anything else you would like us to know?
BEFORE YOU SUBMIT
Please review all information to make sure everything is accurate.
Registration is NOT complete without first payment
Upon submission, one of our representatives will contact you to complete your registration process.
Submit
Thanks for submitting! We will be in contact with you shortly!
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