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:

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

Other

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

Are you interested in AM or PM classes?

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:

Parent/Guardian Name:

First NameLast Name

Relationship to Child:

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