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Bethany Afterschool Program - Registration Form

Registration:
Step 1: Fill out form and Submit

Step 2: You will receive instructions to download the Procare app.

Parent/Guardian Information

After School Program Details

Second Parent/Guardian Information

Student Information

Race, ethnicity (may choose multiple)

Medical and Emergency Contact Information

Disclaimer Agreement

to School Connect WA and Bethany Community Church, its representatives, employees, and any affiliated organizations, to use photographs and/or videos of my child, for use in School Connect WA's and Bethany Community Church's official media platforms, including but not limited to:  

  • Website, social media accounts (Facebook, Twitter, Instagram, etc.)

  • Promotional materials (brochures, flyers, posters, etc.)

  • Presentations and reports

I understand that these images may be used for informational, promotional, or educational purposes, and may be published in various mediums, including print, online, and social media.  I hereby release and discharge School Connect WA and Bethany Community Church from any and all claims, liabilities, demands, actions, and causes of action that I or my child may have against School Connect WA or Bethany Community Church in connection with the use of the photographs and/or videos, including any claims of defamation, invasion of privacy, or infringement of moral rights.  I also understand that no royalty, fee, or other compensation shall become payable to me or my child by reason of such use.  I acknowledge that I have read and fully understand the terms of this media release and waiver, and I hereby consent to its terms.

Calendar: Open when Seattle Public Schools is open

Open Daily: M-F from 2:30 pm to 5:30 pm includes 1 hour of literacy, 1 hour of math.

Transportation: Students are picked up from Daniel Bagley Elementary and walked to Bethany Community Church. No other transportation is provided.

Cost: $625/month 

Summer Program (2025)

Students currently enrolled in Bethany's afterschool program will have priority enrollment for the 5 week summer program. Summer program hours: M-F 9 am to 3:30 pm.

In consideration of my child(ren)’s participation in School Connect WA, I hereby agree on behalf of myself, my child(ren) named herein, my heirs, executors, and assigns to waive, release, discharge, indemnify, and hold harmless School Connect WA and Bethany Community Church, its officers, employees, volunteers, and agents from all claims, suits, and liability, whether for personal injury, acts of negligence, illness, and/or property loss or damage, arising from, but not limited to, my participation or my child(ren)’s participation in any School Connect WA, Bethany Community Church, after school program, session, activity, or camp, or any willful or negligent tort that occurs on Bethany Community Church or School Connect WA property. I further waive any and all claims and release School Connect WA and Bethany Community Church from liability for personal injury, damage, illness, or loss incurred or as a result of the actions or omissions of any third party while participating in activities in connection with School Connect WA. I voluntarily agree to waive any and all causes of action in connection with the above, whether based in contract, tort, or otherwise, to the extent allowed by applicable law.

Media Release Permission

FAQ

Q: What is School Connect WA?

A: School Connect WA is a 501(c)(3) nonprofit organization dedicated to bridging literacy and math gaps for elementary students in under-resourced communities. We achieve this goal through high-impact tutoring and by collaborating with teachers and parents to identify and address academic disparities.

Q: How is parent communication handled?

A: We utilize the Procare Mobile App for all communication with parents. You will receive instructions to download the mobile app after completing the registration above.

Q: If School Connect WA is a nonprofit, why is the cost $625/month?

A: The afterschool program at Bethany Community Church is offered free of charge for McKinney-Vento (unhoused) students and low-income students. Additionally, there are a limited number of "market price" enrollment slots available, which help offset overall expenses.

Q: How do I pay the program fee?

A: We accept cash, check, or you can pay online through the Procare app.

Q: Instead of paying the program fee, can I donate the amount to School Connect WA?

A: YES. Your donation is 100% tax deductible. You must setup your donation online as an automatic monthly gift. Go to: www.schoolconnectwa.org/donate

Q: Do you offer a summer program?

A: YES. To prevent the "summer academic slide" we host a five-week summer program that provides high-dosage tutoring and enrichment activities.

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