Beibei Amigos Registration Form DES

Bei Bei Amigos Student Registration Form

2023-2024 School Year
Student Information

Before submitting this form please contact Beibei Amigos Language Preschool
Please Select Desired Starting Date*

MonthDayYear
Date
Student Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
FemaleMale
YesNoShowing InterestNot Interested
YesNo
If yes, please specify Allergy/Restriction & Reaction

Emergency Contact

This section is mandatory and families must provide at least two emergency contacts
1st Emergency Contact*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
2nd Emergency Contact*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
3rd Emergency Contact

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
4th Emergency Contact

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.

Emergency Contact Card, Immunization Records and Birth Certificate
You must download the Emergency Contact Form First and then once completed you will upload it below.

Click Below to Download the form and upload it below.

CLICK HERE TO DOWNLOAD THE EMERGENCY CONTACT FORM
UPLOAD your completed Emergency Contact Form Here*

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Immunization Records

All Children must have proof of immunizations, or a valid exemption for medical reasons (including lab evidence of immunity) or religious beliefs
Upload A Copy of Your Updated Immunization Record*

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Student Birth Certificate
Upload A Copy of child's Birth Certificate*

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Financial Policy
I have read the financial policy in its entirity and agree to comply with the terms stated herein.
Financial Policy*
Photo and Filming Release
I agree to my Child being Filmed or PhotographedPlease Exclude my Child from any Filming or PhotosOnly Photos/Videos to be used in Procare
Photo and Filming Release Permission*
Drop-Off & Pick-Up Policy

I am responsible for signing my child In/Out on the signing system provided by the center when they arrive and when I take them home
I understand this is a State regulationI will make sure that any other caregiver that is dropping-off or picking-up my child will sign them In/OutI understand that I will have to return to school within an hour if I miss a sing In/Out or I will be charged $15If the sign In/out process doesn't go through, I will contact the Director or any staff immediately
Drop-Off & Pick Up Policy*
Permission to Apply Diaper Ointment

For Students under 3 ONLY
I, the parent/guardian of the above named child, give permission to the staff of Beibei Amigos to apply the following topical diaper ointment that I have provided: *
Permission to Apply Diaper Ointment *

Bei Bei Amigos Student Registration Form