Busy Beavers Academy

Fill out the form completely and a representative will contact you within 24 hours to finish the registration process on-site. Registration includes a $75.00 non-refundable registration fee which can be paid online at the end of this registration form.

Need help? Have questions? Contact us at info@busybeaversacademy.com or give us a call at (971) 301-4266.

Name of Child:

First NameMiddle NameLast Name

Nickname:

Date of Birth:

Gender:

MaleFemale

Is your child currently enrolled in another preschool program/Head Start?

NoYes - Name of Program:Other

Which program are you interested in? **As of 7/21/19, only Tuesday/thursday classes have open spots. others are waitlisting**

Monday/Wednesday/FridayTuesday/ThursdayMonday/Tuesday/Wednesday/Thursday/Friday

Are you interested in AM or PM classes?

AM Classes (8:30 AM - 11:30 AM)PM Classes (12:30 PM - 3:30 PM)

Is your child currently receiving any services, such as WESD?

Does your child have any allergies?

Does your child have any special concerns?

Parent/Guardian Name:

First NameLast Name

Relationship to Child:

ParentLegal GuardianFoster ParentOther:

Parent/Guardian Name:

First NameLast Name

Relationship to Child:

ParentLegal GuardianFoster ParentOther:

Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number:

Area CodePhone Number

Email:

example@example.com

Emergency Contact Information:

First NameLast Name

Relationship:

Phone Number:

Area CodePhone Number

Name of Individuals Authorized To Pick Up Child:

First NameLast Name

Busy Beavers Academy

Child Information

Family Information

Payment Information

Credit Card