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Enroll in our 2024 Summer Program!

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 Summer Program Activities during the 2024 summer term.*

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!

Fill out this submission form to apply for our Summer Program, and a staff member will be with you shortly. If you would like, you can even set a time and date for us to call you!

 

REGISTRATION FEE: $30 

(THIS FEE COVERS REGISTRATION AND SUMMER PROGRAM T-SHIRT). 

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