Peace Before / After Care Scheduler Registration

Welcome to the Peace BAC Scheduler Registration Page! Please fill in the information on each tab below and click "Submit" when finished.

The BAC Coordinator will review your registration information. You will receive an email with login information when your BAC Scheduler account has been activated.

Required fields are marked with a *. Fields that are underlined have popup help text. Please contact the BAC Program Coordinator for a registration code.

Please view the BAC Scheduler FAQs or contact the BAC Program Coordinator if you have any questions.

Family & Medical

Family
*Family Last Name:
*Father's First Name:
*Father's Last Name:
*Mother's First Name:
*Mother's Last Name:
*Email:
*Primary BAC Scheduler User: Father Mother
Medical
*Dentist Name:
*Dentist Phone:
*Physician Name:
*Physician Phone:
*Hospital Name:
*Hospital Emergency Room Phone:
*Medical Insurance Company Name:
*Medical Insurance Policy Number:

Children

Please add all of your children that will be in BAC.

Rates: $5.00/hr. for K3 and K4, $4.00/hr. for grades K-8. A 1 hour minimum will be charged.

Note: Children at school past 11:15am or 3:15pm unsupervised will be placed in After Care.


Child #1
*First Name: Daily Medicines:
*Last Name:
*Grade: Allergies:
*Days Attending: Monday
Tuesday
Wednesday
Thursday
Friday
Medical Conditions:

Qualified Drop-off / Pick-up Persons

(Please indicate parent's names as well as any other drop off / pick up persons.)

Person #1
*First Name:
*Last Name:
*Relationship:
*Home Phone:
*Cell Phone:
Work Phone:
*Street Address:
*City:
Person #2
First Name:
Last Name:
Relationship:
Home Phone:
Cell Phone:
Work Phone:
Street Address:
City:
Person #3
First Name:
Last Name:
Relationship:
Home Phone:
Cell Phone:
Work Phone:
Street Address:
City:
Person #4
First Name:
Last Name:
Relationship:
Home Phone:
Cell Phone:
Work Phone:
Street Address:
City:

Emergency Contacts

In the event that a parent cannot be reached, please contact:

Primary
Same as Drop-off / Pick-up Person: Person #1
Person #2
Person #3
Person #4
*First Name:
*Last Name:
*Relationship:
*Home Phone:
*Cell Phone:
Work Phone:
Secondary
Same as Drop-off / Pick-up Person: Person #1
Person #2
Person #3
Person #4
*First Name:
*Last Name:
*Relationship:
*Home Phone:
*Cell Phone:
Work Phone:

Agreements & Consent

Please read the following agreements and check the box below. Checking the box means that you agree to the terms and provisions outlined below.

Registration/Fee Agreement

This agreement must be made by the person(s) who will be responsible for the payment of fees. Fees will be paid online at the church website. An up-to-date email address is needed to submit daycare calendars and to receive invoices regarding your daycare fees. We will also be using email to notify parents of changes in daycare policy or other information. Please read this carefully so that you understand it.

I (We) am (are) registering for Peace Lutheran School's Before and After Care Program (BAC). If I (we) modify this schedule, it must be done through the online BAC Scheduler and/or the BAC Coordinator. At the same time, I (we) agree to pay the fees ($5.00/hr. for K3 and K4, $4.00/hr. for grades K-8) for that schedule as well as the once yearly $25.00 registration fee per family. For planning purposes we are asking that the registration fee be paid by check for K-8 children on Registration Day in August or for K3/K4 children on Orientation night in August at the BAC table. Note: Please see all schedule policies in the BAC handbook at http://www.peacewels.org.

Emergency Medical Consent

In order to protect the health and safety of its students, Before and After Care may need to obtain emergency medical treatment for students when the parents are not available. Therefore, the School must respectfully require that Parents/Guardians of all students at Peace Lutheran School must agree to this policy. By checking the box below, the parent authorizes the School administration, teachers and coaches to seek medical treatment by EMT, physician or hospital staff in the event that (a) the student has sustained an injury or developed an illness which may, in the discretion of the school staff, substantially endanger the child's health if not treated immediately and (b) the student's parent could not be reached. This authorization also authorizes release of the student's medical records and information to the treating provider to the extent necessary to provide immediate medical treatment. The parent or guardian releases Before and After Care and its staff members from liability for seeking such treatment, for the treatment which is obtained, and for the results of that treatment. This permission covers all activities in which the student chooses to participate as a student of Before and After Care. I hereby give permission for transportation via ambulance to a local hospital and for medical treatment deemed necessary by a physician who is designated by the school authority. I understand that Before and After Care will attempt to obtain treatment from preferred physicians and hospitals, but may seek treatment from any provider if necessary.


I (We) have read the above statements, attached policies and handbook of Peace Lutheran School and Peace Lutheran Before and After Care Program, and agree to register my (our) child(ren) in the program, and to be responsible for the regular monthly online payment fees including the $25.00 registration fee per family and any additional amounts due for late fees.

*Please enter a registration code: