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School Year '24-'25
Enrollment Form

*For registration please complete the registration form below,

or

Complete

Fillable PDF Form

then email the completed form to info@bbnsacademy.com.

You may also stop by and ask our team for an application!

Child's First and Last Name*

Gender*

Age*

Date of Birth*

Grade*

Home Address*

Child's Shirt Size*

Will you be needing transportation?*

Parent/Guardian Name*

Parent/Guardian Address

Parent/Guardian Email Address

Parent/Guardian Cell Phone Number*

Parent/Guardian Work Phone Number

OTHER THAN YOU, who is able to pick up your child(ren).*

Child's Medical Information

Emergency Contact*

My Child has permission to fully participate in BBNS Academy's  Activities during the 2024-2025 School Year.*

I authorize BBNS Academy to use a photograph or other image of my child for public relations purposes connected to the summer camp program and future programs associate with BBNS Academy*

I hereby give permission to BBNS Academy for my child(ren) to participate in excursions involving transportation and consent to give BBNS Academy permission to transport my child for program purposes.*

I agree to a financial contract that will be established between myself and BBNS Academy and hereby set the enrollment date as the one discussed with staff. I agree to physically sign a financial agreement as well.*

I hereby agree to sign an electronics waiver upon registration.*

We will follow up with you, what date are you available?

We will follow up with you, what time are you available? Thank you!

4068 Oakmont Drive

 Pontoon Beach, IL 62040

 P:(618)-501-4141

F:(618)-270-4059

info@bbnsacademy.com

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