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MWS New Student Registration Form

HomeMWS New Student Registration Form

"*" indicates required fields

Student Name*
Date of Birth*
Address*

Before & After Care Needs

Care Needed*
MM slash DD slash YYYY
Before Care Payment Schedule*
After Care Payment Schedule*
Select the days you will need DAILY Before Care*
Select the days you will need DAILY After Care*

Parent/Guardian Information

Parent Name*
Email*

Medical Information & Health History

Physician Name*
Emotional/Behavioral/Physical/Medical Issues*
Does your student take medications?*
Food Allergies*
Environmental Allergies*

Authorized Pick-Up & Emergency Contact

In case of emergency, please provide at least 2 different people with 2 different numbers
Parent/Guardian*
Emergency Contact*
Additional Contact

Required Documentation

Please upload required documents here. This can be completed now or later through the website. All documents must be completed in its entirely and submitted at least 1 week prior to anticipated start date
Complete with at least 2 emergency contacts and a signature
Max. file size: 256 MB.
Part I, Part II, Lead Certificate, Immunization Record
Drop files here or
Max. file size: 256 MB, Max. files: 4.
    Mandatory if child has asthma or allergies To be completed by doctor
    Drop files here or
    Max. file size: 256 MB, Max. files: 4.
      Mandatory if child has asthma To be completed by doctor
      Drop files here or
      Max. file size: 256 MB, Max. files: 2.
        Mandatory if child has allergies To be completed by doctor
        Drop files here or
        Max. file size: 256 MB, Max. files: 2.

          Consent, Contract & Waivers

          Code of Conduct*
          UEC staff is committed to providing a safe, positive and structured environment for all children in the after school program. During childhood, children are learning to be in charge of their own behavior. We establish consistent, easy to understand limits. When out-of-bounds behaviors do occur, it is important for children to understand why the behavior is inappropriate and how to modify it. We work to prevent behavior problems by arranging the setting so that children work in small groups and have a choice of activities. The range of activities will give the child the freedom and ability to experience success and become self-directed. Children are encouraged to verbalize their feelings in order to learn to positively work through strong emotions. Teachers act as role models and encourage children’s appropriate behaviors. We will provide developmentally appropriate verbal explanations and guidance to help children gain confidence and social problem-solving skills. Appropriate behavior is expected and all efforts will be made to assist children in adjusting to the program setting.
          Covid-19 Waiver*
          I acknowledge that I have independently reviewed the risks of exposure to COVID-19 in light of my child’s and my family’s personal health conditions, and I have decided to allow my child to attend camp with full knowledge of these risks and expectations described in this form. 
          UEC Contract/Waiver of Liability*
          I acknowledge that I have read and understand UEC's policies as it relates to Registration, Procedures and Routines, Activity Schedule, Communication, Payment Procedures, Payment Schedule and Tuition. I understand a listed adult on the registration form must sign all students out daily. I understand that if my child is not picked up on time, I will be assessed a $1.00 per minute late fee thereafter, due at pickup. I acknowledge that my child and I have read and understand UEC’s rules and regulations. I understand that if my child is suspended/ expelled from UEC for any reason, it is at my expense and I am not entitled to a refund. I have insurance and recognize the risk of injury, illness or death. I, the legal guardian give permission for my child to participate in all activities offered by UEC, bus field trips, outside activities on or off site. I knowingly assume all risks and dangers inherent and incidental to the activities and thereby will not sue or hold BCPSS and/or United Educational Corp Programs or staff liable for any injuries or damages. I will administer all medication at home. UEC will only administer medications in emergency situations. I authorize UEC and staff to transport my child in the event of a field trip or medical emergency. I hereby grant UEC permission to use my child's likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration. I understand and agree that all photos will become the property of the UEC and will not be returned. 

          Payment

          Credit Card*
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