After School Program - Registration

PERMISSION TO SIGN OUT OF PROGRAM

Some parents may choose to give their child permission to sign themselves out of program in order to walk home or leave with non-approved persons (friends, family, etc.). Please indicate below if your child has permission to sign themselves out:
Yes, my child has permission to sign themselves out of programmingNo, my child may not sign themselves out of programming
You have indicated you do not wish your child to sign themselves out of programming. Please identify two approved adults who have permission to pick your child up from programming. These adults will be required to show Photo I.D. to staff onsite in order to release your child from programming.
Name of Approved Adult

First NameLast Name
Name of Approved Adult

First NameLast Name
AUTHORIZATION

Registration will not be processed without a signature below.

I consent for my child to participate in BGCL's After-School Program at the designated site selected.
Parent or Guardian's Name*

First NameLast Name
Parent or Guardian's Signature*

Clear
Date Signed

MonthDayYear
Date
Hour MinutesAM/PM Option
Should be Empty: