BrentwoodBaptist.com/bycs. Today's Date. Child's Name q Male q Female. Date of Birth. Street Address. City. State. Zip C
A Ministry of Brentwood Baptist Church 7777 Concord Road, Brentwood, TN 37027 Phone 615.324.6117 • Fax 615.324.6192 BrentwoodBaptist.com/bycs
REGISTRATION 2017-2018
A $75 non-refundable registration fee is required at the time of registration. Today’s Date Child’s Name q Male
q Female
Date of Birth
Street Address City State Zip Code Mother’s Name
Father’s Name
Home Phone
Home Phone
Work Phone
Work Phone
Cell Phone
Cell Phone
Email Email
Member of Brentwood Baptist Church?
q Yes q No
Regular Attender of Brentwood Baptist Church?
q Yes
q No
Other Church Affiliation Does your child have any allergies?
q Yes q No
Does your child require an EpiPen?
q Yes
q No
q Yes
q No
What language is spoken in your home? Is a parent or legal guardian serving on active duty in the armed forces of The United States?
Please check the desired programs and, if appropriate, indicate 1st choice and 2nd choice: The birthdate ranges below show which program(s) your child is eligible for. If needed, you may refer to the birthdate chart in the BYCS registration information brochure. Program
Birthdate Range
Meets On
Hours
Tuition
2-Day
04/01/14–02/29/17
Tue/Thu
9:00 AM–2:30 PM
$245
3-Day*
01/01/12–09/30/14
Tue/Wed/Thu
9:00 AM–2:30 PM
$355
4-Day*
01/01/12–08/15/13
Mon–Thu
9:00 AM–2:30 PM
$465
* Must be potty-trained and NO pull ups. Office Use Only
