Register Here Early Bird Registration for current families, BPCC alumni families, and members of the First Presbyterian Church of Bakerstown will open at 12 noon on Sunday, January 22. Open registration will begin on Monday, January 30 at 12 noon. Child Registration Form Mother's First Name Mother's Last Name Mother's Cell PhoneMother's Email Father's First Name Father's Last Name Father's Cell PhoneFather's Email Name of Primary Contact Person(Required) Email Address of Primary Contact Person(Required) Address of Primary Contact Person(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country In which school district do you reside?(Required) How did you first hear about Bakerstown Presbyterian Children's Center? Word of Mouth Social Media Other How Many Children Would You Like to Register?(Required)123Information for Child 1:First Name of Child 1(Required) Last Name of Child 1(Required) Gender(Required) Boy Girl Birth Date(Required) Age of Child 1 (as of Sept 1, 2023)(Required)2345Does this child reside at the address of the primary contact person listed above?(Required) Yes No Address Where This Child Resides Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Does this child have any allergies?(Required) Yes No Known Allergies (if applicable)Please list any custody issues:Does this child have any special needs, receive any services (eg speech) or require any accommodations?(Required) Yes No Please explain belowRank Your Choice of Class Times for Child 1:BPCC adheres to the Pine-Richland School District birthday deadlines for enrollment. Each child must be 2, 3, 4, or 5 years of age by September 1, 2023 to be enrolled in the corresponding class. Please indicate your 1st, 2nd and 3rd choice preferences using the drop-down options below. First Choice (Child 1) – 2sM/W 9-11:30am WAITLISTT/Th 9-11:30am WAITLISTMommy & Me Tuesday 9:30-11amSecond Choice (Child 1) – 2sM/W 9-11:30am WAITLISTT/Th 9-11:30am WAITLISTF 9-11:30amMommy & Me Tuesday 9:30-11amThird Choice (Child 1) – 2sM/W 9-11:30am WAITLISTT/Th 9-11:30am WAITLISTMommy & Me Tuesday 9:30-11amFirst Choice (Child 1) – 3sT/Th 9:00am-11:30amM/W/F 9:00am-11:30am WAITLISTM/W/F 12:30pm-3:00pmSecond Choice (Child 1) – 3sT/Th 9:00am-11:30amM/W/F 9:00am-11:30am WAITLISTM/W/F 12:30pm-3:00pmThird Choice (Child 1) – 3sT/Th 9:00am-11:30amM/W/F 9:00am-11:30am WAITLISTM/W/F 12:30pm-3:00pmFirst Choice (Child 1) – 4sM/W/F 9:00am-11:30amM/T/W/Th 9:00am-11:30am WAITLISTM/T/W/F 9:00am-11:30am WAITLISTM/W/F 12:30pm-3:00pmSecond Choice (Child 1) -4sM/W/F 9:00am-11:30amM/T/W/Th 9:00am-11:30am WAITLISTM/T/W/F 9:00am-11:30am WAITLISTM/W/F 12:30pm-3:00pmThird Choice (Child 1) – 4sMWF 9:00am-11:30amMTWTh 9:00am-11:30am WAITLISTMTWF 9:00am-11:30am WAITLISTMWF 12:30pm-3:00pmFirst Choice (Child 1) – Pre-KMTWTh 9am-12noonInformation for Child 2:First Name of Child 2 Last Name of Child 2 Gender Boy Girl Birth Date Age of Child 2 (as of Sept 1, 2023)(Required)2345Does Child 2 reside at the address of the primary contact person listed above? Yes No Address Where This Child Resides Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Does Child 2 have any allergies? Yes No Known Allergies (if applicable)Please list any custody issues:Does Child 2 have any special needs, receive any services (eg speech) or require any accommodations? Yes No Please explain belowRank Your Choice of Class Times for Child 2:First Choice (Child 2) – 2sM/W 9-11:30am WAITLISTT/Th 9-11:30am WAITLISTMommy & Me Tuesday 9:30-11amSecond Choice (Child 2) – 2sM/W 9-11:30am WAITLISTT/Th 9-11:30am WAITLISTMommy & Me Tuesday 9:30-11amThird Choice (Child 2) – 2sM/W 9-11:30amT/Th 9-11:30am WAITLISTF 9-11:30amMommy & Me Tuesday 9:30-11amFirst Choice (Child 2) – 3sT/Th 9-11:30am WAITLISTMWF 9-11:30am WAITLISTMWF 12:30-3pmSecond Choice (Child 2) – 3sT/Th 9-11:30am WAITLISTMWF 9-11:30am WAITLISTMWF 12:30-3pmThird Choice (Child 2) – 3sT/Th 9-11:30am WAITLISTMWF 9-11:30am WAISLISTMWF 12:30-3pmFirst Choice (Child 2) – 4sMWF 9am-11:30amMTWTh 9am-11:30amMTWF 9am-11:30amMWF 12:30pm-3pmSecond Choice (Child 2) -4sMWF 9am-11:30amMTWTh 9am-11:30amMTWF 9am-11:30amMWF 12:30pm-3pmThird Choice (Child 2) – 4sMWF 9am-11:30amMTWTh 9am-11:30amMTWF 9am-11:30amMWF 12:30pm-3pmFirst Choice (Child 2) – Pre-KMTWTh 9am-12noonInformation for Child 3:First Name of Child 3 Last Name of Child 3 Gender Boy Girl Does Child 2 have any allergies? Yes No Birth Date Age of Child 3 (as of Sept 1, 2023)(Required)2345Does Child 3 reside at the address of the primary contact person listed above? Yes No Address Where This Child Resides Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Does Child 3 have any allergies? Yes No Known Allergies (if applicable)Please list any custody issues:Does Child 3 have any special needs, receive any services (eg speech) or require any accommodations? Yes No Please explain belowRank Your Choice of Class Times for Child 3:First Choice (Child 3) – 2sM/W 9-11:30amT/Th 9-11:30am WAITLISTF 9-11:30amMommy & Me Tuesday 9:30-11amSecond Choice (Child 3) – 2sM/W 9-11:30amT/Th 9-11:30am WAITLISTF 9-11:30amMommy & Me Tuesday 9:30-11amThird Choice (Child 3) – 2sM/W 9-11:30amT/Th 9-11:30am WAITLISTF 9-11:30amMommy & Me Tuesday 9:30-11amFirst Choice (Child 3) – 3sT/Th 9-11:30amMWF 9-11:30am WAITLISTMWF 12:30-3pmSecond Choice (Child 3) – 3sT/Th 9-11:30amMWF 9-11:30am Class on WaitlistMWF 12:30-3pmThird Choice (Child 3) – 3sT/Th 9-11:30amMWF 9-11:30am WAITLISTMWF 12:30-3pmFirst Choice (Child 3) – 4sMWF 9am-11:30amMTWTh 9am-11:30am WAITLISTMTWF 9am-11:30amMWF 12:30pm-3pmSecond Choice (Child 3) – 4sMWF 9am-11:30amMTWTh 9am-11:30am WAITLISTMTWF 9am-11:30amMWF 12:30pm-3pmThird Choice (Child 3) – 4sMWF 9am-11:30amMTWTh 9am-11:30am WAITLISTMTWF 9am-11:30amMWF 12:30pm-3pmFirst Choice (Child 3) – Pre-KMTWTh 9am-12noonSubmit Your InformationOnce you submit the information, you will be directed to a payment page to make a deposit. (Your registration will not be complete until you submit the payment.)EmailThis field is for validation purposes and should be left unchanged. Δ