• Summer SMART Registration Form

    For Information Regarding Fees or usage of EEC Vouchers contact Ms. Tina Baker @BBTMusic 781-479-8327 tbaker@bbtmusic.org
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  • Member Information

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  • Parent/Guardian  Information

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  • Parent/Guardian 1 Work Information

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  • Parent/Guardian 2 Information

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  • Parent/Guardian 2 Work Information

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  • Emergency Contacts and Authorized Pick-Ups

    In case of emergency, Parents/Guardians are always contacted first.
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  • ALLERGY INFORMATION

    PLEASE COMPLETE THIS FORM EVEN IF YOUR CHILD HAS NO KNOWN ALLERGIES
  • If your child does use a medication in the event of an emergency exposure, please bring the LABELED medication with FULL WRITTEN INSTRUCTIONS FOR USE AND UNDER WHAT SPECIFIC CONDITIONS IT SHOULD BE ADMINISTRATED. 

  • Medical Permission Form:

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  • Medical Records and Custody

  • I certify the documentation of physical examination and immunization in accordance with public school health requirements and lead paint poisoning screening in accordance with public health requirements are on file at my child's school

  • Medication Consent form

  • I parent/guardian named below, give permission to BBTMusic authorized staff members to administer medication to my child as indicated above. 

  • Building Bridges Through Music Activity Permission

  • I give permission for my child {studentsName} to participate in Building Bridges Through Music Inc. programs and be transported by Building Bridges Through Music Inc. staff to and from these activities, field trips, and school centers. I understand that my medical coverage is the primary insurer for my child and will not hold Building Bridges Through Music Inc. responsible in case of an accident.

  • I  give permission for images in print and electronic form and videos taken of my child during the program to be used for public relations purposes, in the newsletter, brochures, annual reports, and for publicity on our website, radio, television, and newspapers. 

  • PARENT HANDBOOK SIGN-OFF SHEET 

    I have read and understood all the policies in the Building Bridges Through Music Inc. After School Program Handbook. 

    I agree to follow the handbook policies accordingly. I do understand that all policies will be enforced, and failure to comply with the policies is a reason for immediate termination. 

     


  • The following is used for grant writing purposes only. It will not be shared and your name will never appear next to the information.

  • BBTM Office use only:  

  • Registration Form

    • Site Visit and/or enrollment meeting (New families)
    • Verification Form - Arrival and departure
    • Medication Consent form 606 CMR
    • Copy of insurance card
    • Copy of child immunization
    • Photo id of adults picking up non-parents
    • Parent's Handbook Signoff
    • picture of the child (office)
    • Lead paint screening for all children under the age of six.
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