top of page

Home
About Us
Programs
Volunteer
Contact Us

Home
About Us
Programs
Volunteer
Contact Us

Program Registration

DREAM BEYOND
AFTER-SCHOOL
ENRICHMENT PROGRAM

Unlock Your Student’s Potential!

Our holistic after-school program nurtures athletic, academic, and
personal growth, equipping students with the skills they need to excel.

College Exposure
Academic Tutoring
Performance Training
Nutrition & Wellness

Confidence. Skill. Future Readiness.

Top Golf Afterschool.jpg

UNCC Afterschool.jpg

Parent/Guardian Information

Parent/Guardian Last Name*

Parent/Guardian First Name*

Relationship to Student(s)*

Phone Number (Primary)*

Phone Number (Alternate)

Email*

Home Address*

Student(s) Information

Please list each student’s full name, date of birth, gender, and current school.*

Family Race/Ethnicity (applies to all listed children unless noted): Ethnicity:*

Hispanic/Latino

Not Hispanic/Latino

Other

Family Race/Ethnicity (applies to all listed children unless noted): Race (select all that apply): *

American Indian/Alaska Native

Asian

Black/African American

Native Hawaiian/Pacific Islander

White

Other

If any student differs, please list the child’s name and their race/ethnicity in the box provided below:

Emergency Contact (Other than Parent/Guardian)

Name*

Phone*

Relationship to Student(s)*

Medical Information

Allergies (food, medication, environmental)

Medical Conditions or Special Needs

Medications Administered during After-School Program

Physician Name & Contact Info

T-Shirt Size(s) (One Camp Shirt Included)*

Consent - Required for Participation

Please review and check each of the boxes below to indicate your understanding and consent. All must be selected to complete registration.

I consent to my child’s participation in BFIT Big Dreams Youth Inc. programs and activities, including on-site and off-site events under the supervision of staff.

I authorize emergency medical treatment for my child in the event of illness or injury when I cannot be reached, including first aid, transport, and any medically necessary procedures deemed appropriate by licensed professionals.

I consent to the collection and secure storage of my child’s data, including demographic information, attendance, and participation records, solely for program management and reporting purposes. I understand that this data will remain confidential and will not be shared without consent.

I consent to my child’s information being used in anonymous, aggregate evaluation and reporting to improve program quality and fulfill grant reporting obligations. No identifying information will be disclosed.

Optional Consent – Not Required for Participation

Please yes if you consent to the following:

I consent to photographs or video of my child being used in promotional or social media materials for BFIT Big Dreams Youth Inc. *

Yes

No

I consent to receiving periodic program updates via text or email. *

Yes

No

Permission & Waiver

By signing below, I grant permission for my child to participate in all after-school activities and authorize emergency medical care if necessary. I also acknowledge that BFIT Big Dreams Youth, Inc. is not responsible for lost or damaged personal belongings.

Parent/Guardian Signature*

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Date

Month

Day

Year

Big Dreams After-School Experience

$105

Follow Us

Copyright © 2025 Big Dreams Youth - All Rights Reserved. Terms & Conditions | Privacy Policy

Home
About Us
Programs
Volunteer
Contact Us

bottom of page