Student Enrollment Form Page 3
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3STUDENT ENROLLMENT FORM
Transportation
I understand that AlphaBEST staff will greet my child upon arrival each morning and oversee my child's departure each day. I understand that my child must not
be left on school grounds without supervision and that AlphaBEST staff cannot allow my child to leave the program unsupervised. I agree to walk my child into
the school each morning and release my child to a teacher before leaving my child. It is my understanding, for the safety of my child, that it is my responsibility to
notify the AlphaBEST program if my child is absent on the day he/she is enrolled, and it is my responsibility to notify my child's teacher of my child's AlphaBEST
schedule, including any changes, or if he/she will not be attending AlphaBEST extended day. This will ensure that my child is properly transported by his/her
teacher to the bus or the AlphaBEST program after the school day. I hereby give my consent for my child to be transported by AlphaBEST staff to or from
AlphaBEST events.
Child will arrive to the program: (circle one)
Bus
Parent
Child will depart the program: (circle one)
Bus
Parent
Date
Parent Signature
Photo Release
I give permission for photos of my child to be used by AlphaBEST Education , for purposes to include by not limited to Constant Contact Emails
and Newsletters, the AlphaBEST website, social media, flyers, advertisements, brochures , videos and for other marketing purposes. Any
children pictured in these publications will not be identified by name. Please sign below if your preference is for your child to participate.
Date
Parent Signature
Playground Permission
My child, _________________________, has my permission to play on any of the playground equipment located on the
_________________________ Elementary School playground that is used by AlphaBEST extended day program.
Date
Parent Signature
Handbook Agreement
I have received, read and agree to the policies outlined in the Parent Handbook.
Date
Parent Signature
Site Contact Information
I have received a copy of the on site phone number for AlphaBEST and a list of management contact numbers.
Date
Parent Signature
Annual Updates - Please review information to verify accuracy (sign & date for each update)
__________________________
_____________
__________________________
_____________
Date
Director's Signature
OFFICE USE ONLY
IDENTITY VERIFICATION
Place of Birth:
Birth Date:
Birth Certificate Number:
Date Issued:
Other Form of Proof:
Site Manager Signature:
ATTENDANCE
Start Date:
End Date:
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