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District 191 BYC Registration

Session Information:

Session 1- October 17-November 30 (Session 1 is closed)

Session 2- December 5-January 25

Session 3- January 30-April 4

Parents are required to fill out a separate form for each child they are enrolling into the BYC program.

If you need assistance filling out the form in Spanish, please contact Eddieca Ontiveros at 952-707-4142. If you need assistance filling out the form in Somali, please contact Hamde Daoud at 952-707-4153.

*Si desea traducir el formulario, haga clic en la bandera de EE. UU. en la esquina a la derecha de la pantalla.

*Haddii aad jeclaan lahayd in foomka lagu turjumo, fadlan ku dhufo calanka Maraykanka ee ku yaal geeska hoose ee gacanta midig ee shaashadda.

Which session(s) can your student attend?requiredSessions 1 & 2 are no longer available
Sessions 1 & 2 are no longer available

Options for BYC Enrichment activities:

Option 1- The Garage (sound recording and music production, marketing and advertising, video creation)

Option 2- Cooking Matters (learning to cook healthy recipes on a team of students, take home the ingredients to make the same recipes at home for your family)

Option 3- Skaterapolis (learn to Skateboard and create your own skateboard)

Please rank each option as your First Choice, Second Choice or Third Choice.

Students are strongly encouraged to attend all days of the program. By checking "Yes," you understand that students are encouraged to attend all classes and you agree to be responsible for having your child at school. required

Student Information

Student's Namerequired
First Name
Middle (optional)
Last Name
Does your child(ren) speak English as a Second Language?required
Does your child receive Speech or Special Education Services through an I.E.P. or a 504 Plan?
(Street, Apartment Number if applicable, City, Zip Code)

Transportation

All pick-up and drop-off addresses must be within the District One91 transportation boundaries. An enrollment confirmation letter and busing information for all students requesting a bus will be communicated directly to families. Bus stops and schedules may not be the same as school day. 

Does your child need transportationrequired

Parent/Guardian Information

Namerequired
First Name
Last Name
Parent/Guardian relationship to the studentrequired
(Street, Apartment Number if applicable, City, Zip Code)
If a cell phone is used as the home number, please enter the cell number.

Additional Emergency Contact Information

(Name (First and Last Name), Phone Number (XXX-XXX-XXXX)

Learning Goals

 
Please check all the additional instructional support your child requires in the following areas.

Student Health Information

By choosing "Yes," I hereby acknowledge that after school staff will not have access to medications kept at school.required

Signature

  • I understand after school programming requirements for my child.
  • I will ensure my child attends after school programming regularly.
  • I give permission for my child to attend after school programming field trips, if offered.
  • If classes are offered in a Distance Learning model of instruction due to COVID, I will attend the Curriculum Kit pick up date for my student if and when communicated. 

By checking the box below and typing my name below, I am electronically participating in the creation of my child's Continual Learning Plan (CLP), signing my child's after school program registration form, giving permission for my child to attend field trips (if offered), and agreeing to the After School Program requirements.

I agree with the statement above.required
Namerequired
First Name
Last Name