MWS Before and After Care Registration ~ New

Student's Name*

First Last

Student's Date of Birth*

Student's Grade*

Address*

Street Address Address Line 2 City State ZIP Code

Parent/Guardian Information

Parent's Name*

First Last

Phone*

Alternate Phone

Email*

Enter Email Confirm Email

Parent Place of Work*

Authorized Pick-Up & Emergency Contact

Parent/Guardian*

First Last

Relationship*

Phone*

Additional Contact*

First Last

Relationship*

Phone*

Upload Required Forms

Credit Card Authorization

Max. file size: 256 MB.

Emergency Form

Upload Emergency Form Here

Drop files here or

Max. file size: 256 MB.

Health Inventory

Upload Health Inventory Here: Part I, Part II, Immunization Record, Lead Test Certificate

Drop files here or

Max. file size: 256 MB.

Asthma Action Plan & Medication Authorization

This is required if your child has asthma

Drop files here or

Max. file size: 256 MB.

Allergy Action Plan & Medication Authorization

This is required if your child has allergies that require medication

Drop files here or

Max. file size: 256 MB.

Consent, Contract & Waivers

Code of Conduct*

The Code of Conduct is to be read and agreed to by both parent/guardian and student participant. UEC staff is committed to providing a safe, positive and structured environment for all children in the after school program. During childhood, children are learning to be in charge of their own behavior. We establish consistent, easy to understand limits. When out-of-bounds behaviors do occur, it is important for children to understand why the behavior is inappropriate and how to modify it. We work to prevent behavior problems by arranging the setting so that children work in small groups and have a choice of activities. The range of activities will give the child the freedom and ability to experience success and become self-directed. Children are encouraged to verbalize their feelings in order to learn to positively work through strong emotions. Teachers act as role models and encourage children’s appropriate behaviors. We will provide developmentally appropriate verbal explanations and guidance to help children gain confidence and social problem-solving skills. Appropriate behavior is expected and all efforts will be made to assist children in adjusting to the program setting. We want to ensure that your child will have the ultimate experience by having you adhere to a few notes to foster a meaningful experience for your child. To ensure your child’s safety along with the safety of other, we strongly suggest that you go over these absolutes. There will absolutely be no hitting, no spitting, no kicking, no obscene/inappropriate touching, and no obscene/inappropriate language. We reserve the right to cancel any child’s before and/or after care privileges with no refund for breaking any one of the rules. If there is a problem or your child feels there is a problem, we would recommend the child come to an adult staff member so we can resolve the situation immediately. There will be NO PHYSICAL CONTACT tolerated. CHILDREN MUST KEEP THEIR HANDS AND FEET TO THEMSELVES.

I have read and agree to the waiver

Covid-19 Waiver*

I acknowledge the risks of Covid-19 and are allowing my child to attend before/after care I acknowledge that I have independently reviewed the risks of exposure to COVID-19 in light of my child’s and my family’s personal health conditions, and I have decided to allow my child to attend with full knowledge of these risks and expectations described in this form.

I have read and agree to the waiver

UEC Contract/Waiver of Liability*

I have read and agree to the contract/waiver I acknowledge that I have read and understand UEC’s policies as it relates to Registration, Procedures and Routines, Activity Schedule, Communication, Payment Procedures, Payment Schedule and Tuition. I understand a listed adult on the registration form must sign all students out daily. I understand that if my child is not picked up on time, I will be assessed a $1.00 per minute late fee thereafter, due at pickup. I acknowledge that my child and I have read and understand UEC’s rules and regulations. I understand that if my child is suspended/ expelled from UEC for any reason, it is at my expense and I am not entitled to a refund. I have insurance and recognize the risk of injury, illness or death. I, the legal guardian give permission for my child to participate in all activities offered by UEC, bus field trips, outside activities on or off site. I knowingly assume all risks and dangers inherent and incidental to the activities and thereby will not sue or hold BCPSS and/or United Educational Corp Programs or staff liable for any injuries or damages. I will administer all medication at home. UEC will only administer medications in emergency situations. I authorize UEC and staff to transport my child in the event of a field trip or medical emergency. I hereby grant UEC permission to use my child’s likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration. I understand and agree that all photos will become the property of the UEC and will not be returned.

I have read and agree to the waiver

Payment

Annual Registration*

Price:

Payment Method

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

2026-2027 Mount Washington School Registration Form (New Students)

Before and After Care Needs

Parent/Guardian Information

Medical Information and Health History

Authorized Pick-Up & Emergency Contact

Upload Required Forms

Consent, Contract & Waivers

Payment