Big Ideas 2021-2022 After School Application
A separate application MUST be completed for each child registered into the program.
  • STUDENT INFORMATION

    Please ensure all information entered is accurate and current.
  • A separate application must be completed for each student.
  • / /
  • Your student's Identification Number can be found on his/her report card. Please also ask your student this is their school lunch number.

    (If you do not know your child's ID#, please type 999-9999)
  • Check all that applies
  • Check all that applies
  • select all that applies to your student.
  • If YES, you MUST provide supporting documentation and complete the next three questions.
    If No, Please proceed to Parent/Guardian Information.
  • Check all that applies
  • Check all that applies
  • PARENT/LEGAL GUARDIAN INFORMATION

  • - -
  • This is how you will receive updates and notifications via text messaging.
    If your carrier is not listed, please click other and your site supervisor will add your carrier's name at a later date.
  • EMERGENCY CONTACT INFORMATION

    YOU MUST COMPLETE A MINIMUM OF TWO EMERGENCY CONTACT. PLEASE ENSURE INFORMATION PROVIDED IS CURRENT and ACCURATE.
  • - -
  • Emergency contact will be notified for any reason the primary contact does not respond.
  • - -
  • Emergency contact will be notified for any reason the primary contact does not respond.
  • STUDENT HEALTH INFORMATION

    All health conditions including allergies MUST be disclosed to ensure student safety.
  • HELP US GET TO KNOW YOUR CHILD

    We want to get to know your child better so we can provide the best possible experience in our programs.
  • If you marked "None of the Above" on the previous question, please skip the next two questions and sign below. If you marked any other answer on the question above, please answer the remaining questions and sign below.
  • PARENT CONSENTS AND DISCLOSURES

  • If you agree, an additional release form will be provided. This form MUST be completed and notarized before services start.
  • An additional release form will be provided. This form MUST be completed and notarized before services start.
  • An additional release form will be provided. This form MUST be completed and notarized before services start.
  • Family Virtual Learning Consents

  • Your signature below indicates that you have received the above items and that the information on this enrollment form is complete and accurate.