BHCC Out Of School Bash Registration
Register to participate in the Out of School Bash activities. Please complete all sections to ensure safety of each child.
#1 Child's Full Name
*
First Name
Last Name
#2 Child's Full Name
*
First Name
Last Name
#3 Child Full Name
*
First Name
Last Name
#4 Child's Full Name
*
First Name
Last Name
Parent Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Child #1 Date of Birth
*
-
Month
-
Day
Year
Date
Child #2 Date of Birth
*
-
Month
-
Day
Year
Date
Child #3 Date of Birth
*
-
Month
-
Day
Year
Date
Child #4 Date of Birth
*
-
Month
-
Day
Year
Date
Activity are you registering for?
*
Out of School Bash
Date of Participation
-
Month
-
Day
Year
06-13-2026
Do your child(ren) have any medical conditions, allergies, or physical limitations we should be aware of?
*
Emergency Contact Name
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to Emergency Contact
*
Please Select
Parent/Guardian
Spouse/Partner
Sibling
Friend
Other
Liability Waiver
*
Participant Signature (if under 18, parent/guardian must sign)
*
Register Now
Register Now
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