BCA SEP Registration 2024

Brown Christian Academy’s Summer Enrichment Program (SEP) serves children who have completed Kindergarten through 5th grade, and should not be confused with a camp. SEP is designed to review and teach grade-level skills and concepts presented during the student’s current and upcoming academic year. Mrs. Elois Nicholson-Booker serves as the Director for BCA’s Summer Enrichment Program.

There will only be one session of the Summer Enrichment Program offered this year. SEP is four weeks long, beginning June 3^rd through June 28^th. The hours of operation are from 8:00 am to 4:00 pm; with drop-off beginning at 7:30 am. The day is divided up into 60-minute segments with an hour for lunch/recess. Morning sessions are built around core content subjects such as Reading, Writing, Science, and Mathematics. Afternoon sessions will focus on physical movement, Music, Art, Spanish and Technology. New to SEP 2024: Cheer and Theatre offered during Aftercare. Students will attend Chapel daily, led by Pastor Jeff Jackson.

SEP is divided into two sessions. Both sessions are four weeks long, with Session I from June 5-30^th and Session II from July 5-28^th. The hours of operation are from 8:00 am to 4:00 pm; with drop-off beginning at 7:30 am. The day is divided up into 60-minute segments with an hour for lunch/recess. Morning sessions are built around core content subjects such as Reading, Writing, Science, and Mathematics. Afternoon sessions will focus on physical movement, music, art, Spanish and technology. Students will attend Chapel daily, led by Pastor Jeff Jackson

2024 SEP Tuition & Fees

Parent Information Sessions: Informational Sessions (Sunday, May 19^th at 1:30 pm and Thursday, May 23 at 6:30pm) We are offering parents two options for payment. You can either pay in full during one of our Informational Sessions or make weekly installments on Monday of each week. Your first weekly installment will be due on June 3^rd. We do not offer refunds.

Student Information

First Name *

Last Name *

DOB *

Student have an IEP? *

Yes

No

School Last Attended *

Grade in School 2022-2023? *

Gender *

Male

Female

Physical Street Address *

City *

State *

Zip Code *

Phone Number *

Parent 1 Information

Parent #1 *

Father

Mother

Guardian

Full Name *

Cell Number *

Work Number *

Email: *

Mailing Address *

City *

State *

Zip Code *

Place of Employment *

Occupation/Title *

Employment Address *

Employment City *

Employment Zip Code *

Employment State *

Marital Status

Parent 2 Information (Optional)

Parent #2

Father

Mother

Guardian

Full Name

Cell Number

Work Number

Email:

Mailing Address

Marital Status

City

Zip Code

State

Place of Employment

Occupation/Title

Employment Address

Employment City

Employment Zip Code

Employment State

Occupation/Title

Employment City

Employment Zip Code

Employment State

Authorized/Emergency Contact Information

Contact 1 Name *

Contact 1 Phone *

Contact 1 Relationship to Student *

Contact 2 Name

Contact 2 Phone

Contact 2 Relationship to Student

Contact 3 Name

Contact 3 Phone

Contact 3 Relationship to Student

Health and Medical Habits

Does your child have any of the following medical concerns? *

Asthma (Parent or Legal Guardian must complete the Health/Medical Plan)

Allergies (Parent or Legal Guardian must complete the Health/Medical Plan)

Environmental:

Food:

List Medications:

N/A

List Environmental, Food or List of Medications below *

Name of Pediatrician *

Pediatrician Phone *

Acknowledgement

I understand that I will be no)fied in the case of a medical emergency involving my child. In the event that I cannot be reached, I authorize the calling of a doctor and the providing of necessary medical services in the event my child is injured or becomes ill. In the case of an emergency, and if a family physician cannot be reached, I hereby authorize my child to be treated by Cer)fied Emergency Personnel (i.e. EMT, First Responder, and/or Physician).

Parent's Signature: *

clear

I give permission for my child to be photographed during BCA Summer Enrichment Program for the purpose of being published in different media, including social media, newspapers, magazines, videos, and other promotional venues. I understand that although my child’s photograph may be used for advertising, his or her identity will not be disclosed. I do not expect compensation and all photos are the property of Brown Christian Academy.

Parent's Signature: *

clear

Please answer each of the following questions. Has the before-mentioned student applicant…

Repeated a grade or taken summer school? *

Yes

No

Been suspended or dismissed for disciplinary reasons? *

Yes

No

Been recommended for special education classes or been diagnosed with a learning disability, ADD, ADHD, been prescribed medication for ADD, ADHD or similar conditions, received any additional classroom modifications as part of their educational program, or had any childhood illness which might impair his or ability to learn? *

Yes

No

Ever been recommended, screened or tested for any learning disability? *

Yes

No

Had disciplinary concerns outside of school? *

Yes

No

Been recommended for or received professional counseling? *

Yes

No

If yes to any of these please explain *

Registration and Application Fee

Student's Name *

DOB *

Current School *

Grade Level *

Parents' Names *

Address: *

Daytime Phone: *

Cell Phone: *

Email: *

Space is limited to the first 100 applicants with submitted registration, application, and $150 fee (which includes a fully refundable deposit of $100 to secure your child’s spot and a non-refundable $50 application fee. The $100 deposit may be refunded up until Friday, May 24, 2024.

Selection Choice *

Summer Session ($150.00)

Cheer ($40.00)

Theater ($35.00)

BCA SEP T-Shirt Order Form

UNIFORMS: BCA Summer Enrichment Warriors are required to wear Brown Christian Academy T-shirts throughout the Program. Each day students will wear a designated color. T-shirts will also be available for purchase and pickup during Parent Information Sessions. Students will need 4 T-shirts (colors: white, navy, green, grey).

Summer T-Shirt Schedule
• Monday – White
• Tuesday – Navy
• Wednesday – Green
• Thursday – Grey
• Friday - White

Choose your size and enter quantity.

	Toddler (2T) – $12.00
	Toddler (3T) – $12.00
	Toddler (4T) – $12.00
	Toddler (5T) – $12.00
	Youth (x-small) – $12.00
	Youth (small) – $12.00
	Youth (medium) – $12.00
	Youth (large) – $12.00
	Youth (x-large) – $12.00
	Adult (small) – $15.00
	Adult (medium) – $15.00
	Adult (large) – $15.00
	Adult (x-large) – $15.00
	Adult (2-4x) – $15.00

Choose your colors (if you need multiples of a color, comment below)

Navy	Green
Grey	White

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