Beacon Kids Advance Registration

(for Newcomers!)

Welcome to Beacon! We’re excited to meet you.

This form is to help the check-in process for your children operate more quickly and smoothly on your first visit.

Please input parent/guardian and child information below.

Parent/Guardian 1

Please complete all fields in this section.

Name

First Name

Last Name

Relationship to Child

Phone Number

(###)

###

####

Parent/Guardian 2

(Optional) If you input a second parent/guardian, please complete all fields in this section.

Name

First Name

Last Name

Relationship to Child

Phone Number

(###)

###

####

Child 1

Please complete all fields in this section.

Name

First Name

Last Name

Date of Birth

YYYY

Current Grade in School

(For Kindergarten and up only)

Allergies or Medical Notes

My Child Can Have...

For nursery children only (ages 6 months until age 3), we serve goldfish and/or cheerios.

Child 2

(Optional) If you input a second child, please complete all fields in this section.

Name

First Name

Last Name

Date of Birth

YYYY

Current Grade in School

(For Kindergarten and up only)

Allergies or Medical Notes

My Child Can Have...

For nursery children only (ages 6 months until age 3), we serve goldfish and/or cheerios.

Child 3

(Optional) If you input a third child, please complete all fields in this section.

Name

First Name

Last Name

Date of Birth

YYYY

Current Grade in School

(For Kindergarten and up only)

Allergies or Medical Notes

My Child Can Have...

For nursery children only (ages 6 months until age 3), we serve goldfish and/or cheerios.

Child 4

(Optional) If you input a fourth child, please complete all fields in this section.

Name

First Name

Last Name

Date of Birth

YYYY

Current Grade in School

(For Kindergarten and up only)

Allergies or Medical Notes

My Child Can Have...

For nursery children only (ages 6 months until age 3), we serve goldfish and/or cheerios.

Child 5

(Optional) If you input a fifth child, please complete all fields in this section.

Name

First Name

Last Name

Date of Birth

YYYY

Current Grade in School

(For Kindergarten and up only)

Allergies or Medical Notes

My Child Can Have...

For nursery children only (ages 6 months until age 3), we serve goldfish and/or cheerios.

Beacon Kids Advance Registration

(for Newcomers!)

location: 376 Trapelo Rd | Belmont | MA | 02478

Office phone: (781) 819-4222