Best Prep Summer Camp 2023
Best Prep Summer Camp at PS 163Q Registration form for 2023
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Email *
STUDENT INFORMATION
學生信息
Student's Last Name
學生的姓氏
*
Student's First Name
學生的名字
*
Birthday
生日
*
MM
/
DD
/
YYYY
Sex
性別
*
Student's grade to be in September 2023
2023 年 9 月的學生班級
*
Attending school
就讀學校
*
Any siblings attending BPA, if any (Full name)
參加 BPA 的任何兄弟姐妹(如果有)(全名)
*
My child is...
我的孩子是...
*
Street Address (e.g., 123 Main St. Apt 14A)
街道地址(例如 123 Main St. Apt 14A)
*
City
城市中心
*
Zip code
郵政編碼
*
GUARDIAN INFORMATION
監護人信息
Guardian 1 Name
守護者 1 姓名
*
Guardian 1 Relationship to child
監護人 1 與孩子的關係
*
Guardian 1 Phone
守護者 1 電話
*
Guardian 1 email
守護者 1 封電子郵件
*
Guardian 2 Name
守護者2名稱
Guardian 2 Relationship to child
監護人 2 與孩子的關係
Guardian 2 Phone
守護者 2 電話
Guardian 2 Email
守護者 2 電子郵件
Emergency Contact Name
緊急聯絡名字
*
Emergency Phone
緊急電話
*
Emergency Address
緊急地址
*
PROGRAM DETAILS
課程詳情
Program Selection
課程選擇
*
Payment Method
付款方式
*
How did you hear about us?
你是怎麼知道我們的?
*
If you answered "Referral" above, please state child(ren)'s and parent phone number below
如果您在上面回答“推薦”,請在下面註明孩子和父母的電話號碼
Preferred Language
首選語言
Dismissal Information
下課信息
My child may be picked up by the following person(s)
我的孩子可能會被以下人員接走
*
My child may NOT be picked up by the following person(s) (Mark NA if unapplicable)
我的孩子可能不會被以下人員接走(如果不適用,請標記 NA)
*
I give my child permission to walk home (Signature required - please type in your name).
我允許我的孩子步行回家(需要簽名 - 請輸入您的姓名)。
*
Program Policy
計劃政策
BEST PREP POLICY
Certification Statement
In consideration of your accepting my child into this program, I the undersigned, intended to be legally
bound, hereby for myself, my heirs, executors, and administrators, waive and release any and all rights
and claims for damages, that I may have against Best Prep in Schools Foundation, its consultants,
contractors, and employees and all sponsors, and their representatives and successors and assigns for any
and all injuries suffered by my child virtue of his or her participation in this program. I certify that all
information on this form is true and correct. I understand that my statements are subject to verification. I
agree and accept that I will abide by all applicable rules and regulations of this program. I consent to the
enrollment and participation of the child listed above in this program.

Tuition Refund Policy
● Tuition fee for participated period and any fees owned by parents will be deducted automatically
before returning the security deposit/ refund.
● Registration fees are not a part of tuition fee and are NON REFUNDABLE.
● 100% refund if the program is canceled by Best Prep (after participating dates
deduction).
● 80% refund if the program is canceled by the parent before the first scheduled day of the term.
● 60% refund from remaining participation period if the program is canceled by the parent during
the first week (5 school days) of the term.
● 30% refund from remaining participation period if the program is canceled by the parent during
the 2ndweek (10 school days) of the term.
● No refund if withdrawal is initiated after the 2nd week (10 school days) of the term.
● No refund for suspension/ expulsion.

Childcare Behavior Management Policy and Agreement
It is the goal of BEST PREP to provide a healthy, safe, and secure environment for all
participants. Best Prep promotes the character development values of caring, honesty, respect,
and responsibility. Participants who attend Best Prep programs are expected to follow the
behavior guidelines and to interact appropriately with staff and other program participants.

The following behaviors are not acceptable in Best Prep programs:
● Endangering the health and safety of participants and/ or staff members
● Use of profanity
● Acting in a lewd manner
● Stealing or damaging Best Prep, school, or personal property
● Leaving the program site or room without permission
● Engaging in any violent behavior including but not limited to hitting, pushing, biting, etc.
● Continuing to disrupt the program
● Refusing to follow behavior guidelines or program rules

When a participant does not follow Best Prep behavior policy, the following action will
be taken:

● Staff will redirect the participant to a more appropriate behavior
● The participant will be reminded of the behavior guidelines and rules through a
discussion with staff
● A parent/ guardian will be notified that day of the problem by staff
● If the inappropriate behavior continues, a meeting will be scheduled with the guardian so
that together they can determine the appropriate action to take.
● If a participant’s behavior at any time threatens the immediate safety of that participant,
other participants, or staff, BPA may contact the parent/guardian to immediately come
to the site and remove the participant, and the above steps may be skipped.
● Reasons for immediate suspension can include refusal to listen to staff, any incident of
hitting, kicking, biting, or any other unwanted physical contact. Repeated violent
behavior upon returning to the program may lead to permanent expulsion.
● Immediate expulsion will occur if a participant is in possession of any/or using tobacco,
alcohol, illegal drugs, firecrackers, firearms, or explosives.
● If a problem persists and a participant continues to disrupt the program, Best Prep
reserves the right to suspend the participant from participation in the program for a
specified time. Permanent termination from the program will be considered in extreme
situations.

Parent/Guardian Contract & Statement of Understanding
I have read, understand and Best Prep’s behavior management policy (above).
I understand that Best Prep staff and volunteers are not allowed to transport children at any
time outside of the program except for field trips and pick up/drop off transportation services.
Best Prep is not responsible for any contact between its staff and program participants outside
of the program hours.

I understand that I am not to leave my child at the Best Prep program site unless a Best Prep
staff person is there to receive and supervise my child. I understand that my child will not be
allowed to leave the program with an unauthorized person. Any person authorized to pick up my
child must be listed on the registration form, or other arrangements must be made in writing or
by calling Best Prep office and speaking directly to the director to inform us of the change. All
persons picking up Best Prep participants must be prepared to present a photo ID to properly
identify himself/herself. Best Prep reserves the right to deny release of any participant if proper
identification cannot be provided.
I understand that should any person arrive to pick up my child who appears to be under the
influence of drugs or alcohol, staff may choose to not release the child and to call the police for
assistance.

I understand that state law mandates Best Prep to report any suspected cases of child abuse or
neglect to the appropriate authorities for investigation. I understand that the definition of
“neglect” includes not providing reliable emergency pick-up information, non-treatment of
recurring medical/health problems, failure to send a child with proper clothing, and repeated
tardiness when picking up a child.
I understand that at drop off and pick up times, the safety of Best Prep children is of utmost
importance and that drivers should proceed with precaution and according to the procedures as
directed by staff. I understand that if I am late in picking up my child and cannot make other
arrangements for another authorized adult to pick him/her up, I am to call Best Prep as soon as
possible to inform them of my situation, and that I will pay a late fee of $20.00 cash or check
within twenty-four hours for every ten minutes past assigned dismissal time. I also understand
that if lateness occurs more than three times, Best Prep can suspend my child’s registration
until other suitable arrangements are made.

I understand that it is my responsibility to read the announcement letters and notices about
upcoming events/issues. I understand that it is my responsibility to know Best Prep emergency
contact numbers and procedures as stated on the program flier.

I understand that if I have a concern or comment regarding any Best Prep program, I agree to
maintain a courteous and civil manner when addressing staff, and that the staff will do the same.
I understand that Best Prep has the right to terminate childcare arrangements for
parents/guardians who disregard these statements.
I give Best Prep permission to take my child on scheduled field trips of which I have been
notified, and to use any photographs taken of my child in promotional materials for Best Prep.
I have provided Best Prep staff with complete and correct information so that they may best
provide a safe, happy environment.

Waiver of Liability
Parents, guardians and Best Prep recognize that the activities to be engaged in by the children
may occasionally result in injury to a child. The staff of Best Prep will undertake the steps
outlined herein under the ILLNESS/ACCIDENTS, MEDICINE AND EMERGENCY CARE to make
sure that the proper attention is given to these events. However, absent the active negligence of
the staff of Best Prep during the activity involved, no liability will be asserted nor claim made
against Best Prep or any of the individuals employed by Best Prep by reason of such an event.

Photo/Video/Interview Consent
I understand that Best Prep holds events both in-school and away from school. Media
representatives, newspaper and television reporters, photographers, and public-relations
personnel may be present at these special events to record them. In some cases, they may
interview and/or photograph children who participate in these events, including my child
(under supervision of Best Prep personnel). These photographs, videos, and interviews will only
be used to promote Best Prep.
I understand that my child reserves the right to refuse to answer any questions or to participate
in promotional photos, videos, and interviews.

I give permission for my child to be photographed or otherwise recorded during Best Prep
events and activities, and for any and all such photographs and/or recordings to be displayed by
Best Prep in any medium (newsletters, websites, Facebook, etc.) whether now or hereafter known
or developed, for which neither my child or I shall receive monetary compensation or ownership
rights.
I have read the "Policy" (above) and understood the terms and conditions. 
(Please type your name below)
我已閱讀“政策”(上文)並理解條款和條件。
(請在下方輸入您的姓名)
*
STUDENT HEALTH INFORMATION
學生健康信息
Allergies (Please mark "NA" if not applicable)
過敏(如果不適用,請標記“NA”)
*
Please check all that applies to your child
請勾選所有適用於您孩子的選項
*
Required
Doe your child take medication for any condition or illness? (Mark NA if not applicable)
您的孩子是否因任何狀況或疾病服用藥物? (如果不適用,請標記 NA)
*
Are there any activities your child can NOT participate in? (Mark NA if not applicable)Are there any activities your child can NOT participate in? (Mark NA if not applicable)
有沒有您的孩子不能參加的活動? (如果不適用,請標記 NA)
*
For children who need Epinephrine auto-injector and/or inhaler on site

I allow my child to carry his/her epi-pen and/ or inhaler.
(Signature required - please type your name)

對於現場需要腎上腺素自動注射器和/或吸入器的兒童

我允許我的孩子攜帶他/她的 epi-pen 和/或吸入器。
(需要簽名 - 請輸入您的姓名)
Is there anything else you would like us to know?
您還有什麼想讓我們知道的嗎?
* Please review all information to make sure everything is accurate
* Please note registration is not finalized until payment is received
* A representative will be in contact with you via email within 1-2 business days from receiving your application.

* 請檢查所有信息以確保一切準確無誤
* 請注意,在收到付款之前,註冊尚未完成
* 代表將在收到您的申請後的 1-2 個工作日內通過電子郵件與您聯繫。
Thank you!
謝謝你!
A copy of your responses will be emailed to the address you provided.
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