BEL-C PROGRAMS - REGISTRATION FORM

BEL-C Program Intake Form

Our Organization, BEL-C is dedicated to providing holistic, safe, and engaging learning support for children, youth, and the caregivers who guide them — at home and in community.

At Beacons’ Early Learning Collective, every child’s journey is unique. This short form helps us guide you to the right experience for your child based on their age, needs, and interests.

We support learning beyond the classroom through creativity, mentorship, and hands-on exploration.

This form is the first of our 3-step enrollment process. It creates your family profile. You may add up to 3 children. After submission, you will receive links to the Step 2 program registration forms, where you will choose schedules, payment options, and program-specific details.

Thank you for choosing BEL-C — we look forward to learning more about your family and your child(ren).

Parent / Guardian Profile
Parent/ Guardian name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Parent / Guardian E-mail

Confirmation Emailexample@example.com
Preferred method of Contact
Emergency Contact and Authorized Pick-Up
Emergency Contact / Authorized Pick-up Names

First NameLast Name
Emergency Contact / Authorized Pick-up Email
example@example.com
Emergency Contact / Authorized Pick-Up Phone Number

Area CodePhone Number
Authorized Pick-Up Persons
Fill this if different from Emergency Contact
Child(ren)'s Profile
Child

First NameLast Name
Date of Birth

MonthDayYear
Date
What is the current learning setting of your child(ren)?
When would you like your child to begin participating in their selected BEL-C program?
If your response to the above question is "Future", please specify here
Program Selection

Please review the guide below before completing each child’s enrollment section. You will be asked to select the program(s) you are interested in for each child.

Age Group	Program Options
Sprouts (18mths to 5yrs)	Childcare — Hosted by BEL-Haven Drop-in Explorers' Playgroup — By BEYOND Enrichment
Trailblazers (6 to 8 years)	After-School Experiences — BEYOND Microschool / Alternative Learning — The Learning Hub (TLH) Enrichment for Homeschoolers — HomeRoots Learning Circle Saturdays & PD Days — BEYOND Seasonal Camps — BEYOND
Navigators (9 to 12 years)	After-School Experiences — BEYOND Academic Support & Tutoring — The Learning Hub (TLH) Microschool / Alternative Learning — TLH Enrichment for Homeschoolers — HomeRoots Learning Circle Saturdays & PD Days — BEYOND Seasonal Camps — BEYOND
Pathfinders (13 to 16 years)	Academic Support & Tutoring — The Learning Hub (TLH) Microschool / Alternative Learning — The Learning Hub (TLH) Enrichment for Homeschoolers — HomeRoots Learning Circle Saturdays & PD Days — BEYOND Seasonal Camps — BEYOND
Pioneers (17–18 years)	Academic Support & Tutoring — The Learning Hub (TLH) Homeschool Enrichment — HomeRoots Learning Circle Saturdays & PD Days — BEYOND Seasonal Camps — BEYOND

Which age group best describes your child?
Which BEL-C program are you interested in for this child?
Enrolling Siblings

We love welcoming siblings into the BEL-C learning community and value the connections they bring to our programs.

Families enrolling more than one child in the same program schedule (same program and same enrollment dates) may receive a 10% sibling discount on the second child’s fees.
Are you enrolling another child?
This form allows you to include up to 3 children at this stage. Please complete the form for your first 3 children.

Once submitted, contact us at admin@beaconselcollective.ca
Our team will guide you through the next steps for the rest of your family’s enrollment.
Child 2

First NameLast Name
Date of Birth

MonthDayYear
Date
When would you like your child to begin participating in their selected BEL-C program?
If your response to the above question is "Future", please specify here
Which age group best describes your child?
Which BEL-C program are you interested in for this child?
Child 3

First NameLast Name
Date of Birth

MonthDayYear
Date
When would you like your child to begin participating in their selected BEL-C program?
If your response to the above question is "Future", please specify here
Which age group best describes your child?
Which BEL-C program are you interested in for this child?
Transportation Add-on

Limited carpool spots may be available within a defined radius of our locations. Availability will be confirmed after registration.
Will your child be needing transport?
How did you learn about us?
Final Acknowledgement & Next Steps

By submitting this form, I acknowledge that I have read and understood the information above, agree to the stated terms and policies, and authorize BEACONS Early Learning Collective (BEL-C) to use the information provided for program registration and communication.

I also acknowledge that all the information I have provided is accurate and up-to-date.

Next steps:

After submission, you will be guided to the program-specific registration form to complete scheduling, confirm availability, and proceed with payment, where applicable.
Please verify that you are human
Should be Empty:

BEL-C Program Intake Form

Parent / Guardian Profile

Emergency Contact and Authorized Pick-Up

Child(ren)'s Profile

Program Selection

Transportation Add-on